| Jeffrey L Polczinski Psyd Llc | |
|
5555 N Port Washington Rd Suite 304 Glendale WI 53217 | |
| (414) 967-9550 | |
| (414) 967-9550 |
| Full Name | Jeffrey L Polczinski Psyd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 5555 N Port Washington Rd, Glendale, Wisconsin |
| Authorized Official Name and Position | Jeffrey L Polczinski (PSYCHOLOGIST) |
| Authorized Official Contact | 4149679550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey L Polczinski Psyd Llc 5555 N Port Washington Rd Suite 304 Glendale WI 53217 Ph: (414) 967-9550 | Jeffrey L Polczinski Psyd Llc 5555 N Port Washington Rd Suite 304 Glendale WI 53217 Ph: (414) 967-9550 |
| NPI Number | 1124291976 |
|---|---|
| Provider Enumeration Date | 04/11/2008 |
| Last Update Date | 10/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124291976 | NPI | - | NPPES |
| 39131300 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1641057 (Wisconsin) | Primary |
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