Organization
GLORIA D RUTT PSYD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLORIA DIANE RUTT PSYD (PRESIDENT)
(307) 286-4106
Entity
Organization
Contact information
Practice address
2305 COULTER DRIVE, CHEYENNE, WY 82009
(307) 286-4106
(307) 632-6588
Mailing address
2305 COULTER DRIVE, CHEYENNE, WY 82009
(307) 286-4106
(307) 632-6588
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
422
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123535400
—
WY
Enumeration date
09/29/2006
Last updated
09/11/2008
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