Individual
DR. JEFFREY C GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
910 LINCOLN AVE, DETROIT LAKES, MN 56501
(701) 213-0426
(866) 575-3304
Mailing address
1323 23RD ST S, SUITE B, FARGO, ND 58103-3759
(701) 293-7477
(866) 575-3304
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
397
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028531
BCBS OF ND PIN
ND
05
—
054519
—
ND
Enumeration date
04/17/2007
Last updated
04/30/2016
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