Provider Demographics
NPI:1699098541
Name:SCHREY, MARY (MA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SCHREY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2990 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-1744
Mailing Address - Country:US
Mailing Address - Phone:541-654-0957
Mailing Address - Fax:
Practice Address - Street 1:1210 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3573
Practice Address - Country:US
Practice Address - Phone:541-654-0957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-07
Last Update Date:2014-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORT0696106H00000X
CAMFC31959106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist