Provider Demographics
NPI:1285850925
Name:LUTTERMAN, MAUREEN (PHD,LPC,DCC,NCC)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:LUTTERMAN
Suffix:
Gender:F
Credentials:PHD,LPC,DCC,NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82073-0216
Mailing Address - Country:US
Mailing Address - Phone:307-760-1998
Mailing Address - Fax:307-742-9400
Practice Address - Street 1:121 E GRAND AVE
Practice Address - Street 2:SUITE 216
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82070-3600
Practice Address - Country:US
Practice Address - Phone:307-760-1998
Practice Address - Fax:307-742-9400
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC 886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional