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General NPI Number Information
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NPI Number | 1639624935
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Entity Type | Individual
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Provider Name | LORRIE POTEET PH.D,
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Gender | Female
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 3517 HAYFORD AVE
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City | LARAMIE
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State | WY
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Zip | 82072-5098
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Country | US
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Telephone | 307-755-1735
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Fax |
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Provider Business Mailing Address
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Address Line | 3517 HAYFORD AVE
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City | LARAMIE
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State | WY
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Zip | 82072-5098
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Country | US
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Telephone | 307-760-2132
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-1597
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY01580
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License Number State | MO
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