Individual
MRS. COLLEEN MARIE WAXLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA LPC MH LMFT
Contact information
Practice address
3601 CANYON LAKE DR, CHRYSALIS, RAPID CITY, SD 57702
(605) 341-8647
(605) 341-0489
Mailing address
3601 CANYON LAKE DR, RAPID CITY, SD 57702
(605) 341-8647
(605) 341-0489
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2022
SD
106H00000X
Marriage & Family Therapist
Primary
1080
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6575172
—
SD
Enumeration date
01/26/2006
Last updated
09/11/2025
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