Doctor Name: | MRS. COLLEEN MARIE WAXLER |
NPI Number: | 1548230956 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LPC MH LMFT |
License Number: | 2022 |
Business Practice Address: | 3601 Canyon Lake Dr Chrysalis Rapid City, SD - 57702 |
Business Phone Number: | 6053418647 |
Business Fax Number: | 6053410489 |
Mailing Address: | 3601 Canyon Lake Dr, RAPID CITY |
State: | SD |
Postal Code: | 57702 |
Phone Number: | 6053418647 |
Fax Number: | 6053410489 |
NPI Enumeration Date: | 01/26/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2022 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | SD |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |