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Individual

MITCHELL J ROGGENBUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADC

Contact information

Practice address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 463-3447
Mailing address
323 S MINNESOTA ST, CROOKSTON, MN 56716-1601
(218) 463-3447

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301204
MN

Other

Enumeration date
05/13/2008
Last updated
05/13/2008
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