Healthcare Provider Details

I. General information

NPI: 1295751691
Provider Name (Legal Business Name): HELENA A GREGOIRE LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 17TH ST NE
DEVILS LAKE ND
58301-1609
US

IV. Provider business mailing address

111 17TH ST NE
DEVILS LAKE ND
58301-1609
US

V. Phone/Fax

Practice location:
  • Phone: 701-665-2650
  • Fax: 701-665-2650
Mailing address:
  • Phone: 701-665-2650
  • Fax: 701-665-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: