# CENTER FOR PSYCHOLOGICAL AND EDUCATIONAL ASSESSMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326242702
- **Authorized official:** DR. THOMAS VICTOR PETROS PH.D. (PROFESSOR OF PSYCHOLOGY)
- **Authorized official phone:** (701) 777-3260

## Contact information

- **Practice address:** 290 CENTENNIAL DR STOP 7108, 210 MONTGOMERY HALL, GRAND FORKS, ND 58202-6063
- **Practice address phone:** (701) 777-3260
- **Practice address fax:** (701) 777-3454
- **Mailing address:** 290 CENTENNIAL DR STOP 7108, 210 MONTGOMERY HALL, GRAND FORKS, ND 58202-6063
- **Mailing address phone:** (701) 777-3260
- **Mailing address fax:** (701) 777-3454

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 231 | ND | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 14870 | BC BS OF ND | ND |