Provider Demographics
NPI:1063642007
Name:FREY, THERESA MARIE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:MARIE
Last Name:FREY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:THERESA
Other - Middle Name:MARIE
Other - Last Name:BROWNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2500 OVERLOOK TERRACE
Mailing Address - Street 2:MAIL CODE: 116A
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705
Mailing Address - Country:US
Mailing Address - Phone:608-256-1901
Mailing Address - Fax:608-280-7204
Practice Address - Street 1:2500 OVERLOOK TERRACE
Practice Address - Street 2:MAIL CODE: 116A
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705
Practice Address - Country:US
Practice Address - Phone:608-256-1901
Practice Address - Fax:608-280-7204
Is Sole Proprietor?:No
Enumeration Date:2009-07-24
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15527-40183500000X
WAPH60258661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist