Provider Demographics
NPI:1821206129
Name:ALPENGLOW WELLNESS, INC.
Entity Type:Organization
Organization Name:ALPENGLOW WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:LUTTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, DCC, NCC
Authorized Official - Phone:307-760-1998
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY886251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health