Provider Demographics
NPI:1447463740
Name:FREITAG, WENDY J (PHD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:J
Last Name:FREITAG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1200 N MAYFAIR RD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3283
Mailing Address - Country:US
Mailing Address - Phone:414-777-1757
Mailing Address - Fax:414-777-0160
Practice Address - Street 1:1200 N MAYFAIR RD
Practice Address - Street 2:SUITE 390
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53226-3283
Practice Address - Country:US
Practice Address - Phone:414-777-1757
Practice Address - Fax:414-777-0160
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI1705103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical