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Individual

DR. GLORIA DIANE RUTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

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
05/10/2006
Last updated
09/11/2008
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