Provider Demographics
NPI:1336279017
Name:MACZKO, JOELLE D (MA)
Entity Type:Individual
Prefix:MRS
First Name:JOELLE
Middle Name:D
Last Name:MACZKO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:JOELLE
Other - Middle Name:D
Other - Last Name:MEUNIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20 GREAT MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CARVER
Mailing Address - State:MA
Mailing Address - Zip Code:02330-1140
Mailing Address - Country:US
Mailing Address - Phone:508-740-1470
Mailing Address - Fax:
Practice Address - Street 1:20 GREAT MEADOW DR
Practice Address - Street 2:
Practice Address - City:CARVER
Practice Address - State:MA
Practice Address - Zip Code:02330-1140
Practice Address - Country:US
Practice Address - Phone:508-740-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health