Organization
JEFFREY C. GREGORY PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY CHARLES GREGORY PH.D. (LICENSED CLINICAL PSYCHOLOGIST)
(701) 213-0426
Entity
Organization
Contact information
Practice address
1407 24TH AVE S STE 204, GRAND FORKS, ND 58201-6761
(701) 213-0426
Mailing address
16872 S BIG CORMORANT RD, AUDUBON, MN 56511-9480
(701) 213-0426
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
397
ND
251S00000X
Community/Behavioral Health Agency
397
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14458
—
ND
01
—
28534
BCBSND
ND
Enumeration date
07/15/2008
Last updated
05/08/2017
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