Organization
JEFFREY C. GREGORY PHD PC
Active
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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