| Doctor Name: | MS. LAURIE RACHAEL HOMER |
| NPI Number: | 1073717203 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., N.C.C., P.P.C. |
| License Number: | PPC-351 |
| Business Practice Address: | Alpenglow Wellness, Inc., Northgate Office Complex Suite 115, 1465 North 4th St., Laramie, WY - 82073 |
| Business Phone Number: | 3077219099 |
| Business Fax Number: | |
| Mailing Address: | 702 S 23rd St, LARAMIE |
| State: | WY |
| Postal Code: | 820704911 |
| Phone Number: | 3077219099 |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PPC-351 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |