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Individual

SUSAN ADELE WHEELER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCMH CCDC3

Contact information

Practice address
2920 SHERIDAN LAKE ROAD, RAPID CITY, SD 57702-5350
(605) 348-0477
(605) 348-0479
Mailing address
2920 SHERIDAN LAKE ROAD, RAPID CITY, SD 57702-5350
(605) 348-0477
(605) 348-0479

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CCDC3950962
SD
101Y00000X
Counselor
LPCMH2072
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6575440
SD
Enumeration date
10/21/2006
Last updated
07/08/2007
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