Healthcare Provider Details

I. General information

NPI: 1649448853
Provider Name (Legal Business Name): LAURITA PUTEGNAT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 E BLANCO RD
BOERNE TX
78006-2002
US

IV. Provider business mailing address

819 WATER ST STE 300
KERRVILLE TX
78028-5330
US

V. Phone/Fax

Practice location:
  • Phone: 830-249-9328
  • Fax: 830-249-9238
Mailing address:
  • Phone: 830-258-5430
  • Fax: 830-792-5771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number62958
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: