Provider Demographics
NPI:1699852913
Name:VOIGT, ROXANN NMN (LP)
Entity Type:Individual
Prefix:MS
First Name:ROXANN
Middle Name:NMN
Last Name:VOIGT
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 1ST AVE NE
Mailing Address - Street 2:205
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906
Mailing Address - Country:US
Mailing Address - Phone:507-288-5629
Mailing Address - Fax:507-536-9108
Practice Address - Street 1:1500 1ST AVE NE
Practice Address - Street 2:205
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906
Practice Address - Country:US
Practice Address - Phone:507-288-5629
Practice Address - Fax:507-536-9108
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4067103T00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN615820000OtherMHCP