| Gloria D Rutt Psyd Pc | |
|
2305 Coulter Drive Cheyenne WY 82009 | |
| (307) 286-4106 | |
| (307) 632-6588 |
| Full Name | Gloria D Rutt Psyd Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2305 Coulter Drive, Cheyenne, Wyoming |
| Authorized Official Name and Position | Gloria Diane Rutt (PRESIDENT) |
| Authorized Official Contact | 3072864106 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gloria D Rutt Psyd Pc 2305 Coulter Drive Cheyenne WY 82009 Ph: (307) 286-4106 | Gloria D Rutt Psyd Pc 2305 Coulter Drive Cheyenne WY 82009 Ph: (307) 286-4106 |
| NPI Number | 1063504611 |
|---|---|
| Provider Enumeration Date | 09/29/2006 |
| Last Update Date | 09/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063504611 | NPI | - | NPPES |
| 123535400 | Medicaid | WY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 422 (Wyoming) | Primary |
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