Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PS008510L | PA |
N | 103T00000X | Psychologist | PS008510L | PA |
Y | 103G00000X | Clinical Psychologist | 36048 | TX |
Y | 103TC0700X | Clinical Psychologist | 36048 | TX |
N | 103G00000X | Clinical Psychologist | PS008510L | PA |
N | 103TC0700X | Clinical Psychologist | PS008510L | PA |
N | 103G00000X | Clinical Psychologist | PSY1561 | NM |
N | 103TC0700X | Clinical Psychologist | PSY1561 | NM |
N | 103G00000X | Clinical Psychologist | RXC077 | NM |
N | 103TC0700X | Clinical Psychologist | RXC077 | NM |
N | 103TH0100X | Health Service | PS008510L | PA |
NPI | 1558405910 |
---|---|
Provider Name | Dr. Lynette A Pujol |
First Address | San Antonio, TX 78255-2250 |
Second Address | Jbsa Ft Sam Houston, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2007 |
Last Update Date | 06/08/2021 |