Provider Demographics
NPI:1962836890
Name:CHRISTENSEN, ROXANNE MARIE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:MARIE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 WALTON BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1413
Mailing Address - Country:US
Mailing Address - Phone:248-218-0599
Mailing Address - Fax:248-218-0612
Practice Address - Street 1:2490 WALTON BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1413
Practice Address - Country:US
Practice Address - Phone:248-218-0622
Practice Address - Fax:248-218-0612
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6351001879103T00000X
MI6301019262103T00000X, 103TC0700X
MI6301017022103TC0700X
MI6301015091390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program