Healthcare Provider Details

I. General information

NPI: 1962873299
Provider Name (Legal Business Name): ABBY VOIGT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 CLEVELAND AVE S
SAINT PAUL MN
55116-1218
US

IV. Provider business mailing address

670 CLEVELAND AVE S
SAINT PAUL MN
55116-1218
US

V. Phone/Fax

Practice location:
  • Phone: 763-913-8261
  • Fax:
Mailing address:
  • Phone: 763-913-8261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number25522
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: