Individual
JOSEPH S MACIEJKO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4455 E 56TH ST, DAVENPORT, IA 52807-2995
(563) 355-2577
(563) 355-4015
Mailing address
865 LINCOLN RD, STE L10, BETTENDORF, IA 52722-4190
(563) 355-9191
(563) 355-3419
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00085
IA
103T00000X
Psychologist
00240
IA
103T00000X
Psychologist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083568
—
IA
01
—
42652
WELLMARK HEALTH PLAN
IA
01
—
IA0195
JOHN DEERE HEALTH PLAN
—
Enumeration date
10/06/2005
Last updated
07/09/2007
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