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General NPI Number Information
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NPI Number | 1285968586
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Entity Type | Individual
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Provider Name | ELEANOR RACE MACKEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 09/21/2009
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Last Update Date | 09/21/2009
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Provider Practice Location Address
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Address Line | 111 MICHIGAN AVE NW DEPARTMENT OF PSYCHIATRY
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City | WASHINGTON
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State | DC
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Zip | 20010-2916
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Country | US
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Telephone | 202-476-5307
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Fax | 202-476-3966
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Provider Business Mailing Address
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Address Line | 3810 CALVERT ST NW
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City | WASHINGTON
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State | DC
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Zip | 20007-1820
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Country | US
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Telephone | 202-476-5307
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Fax | 202-476-3966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY1000484
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License Number State | DC
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