Provider Demographics
NPI:1831794874
Name:EUSTIS, ELIZABETH H (PHD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:H
Last Name:EUSTIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:#1056 881 WORCHESTER STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760
Mailing Address - Country:US
Mailing Address - Phone:617-977-4770
Mailing Address - Fax:
Practice Address - Street 1:226 MASSACHUSETTS AVE STE 2A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-8449
Practice Address - Country:US
Practice Address - Phone:617-977-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11394103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical