Provider Demographics
NPI:1033340302
Name:COMSTOCK, JOANNE ELENA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:ELENA
Last Name:COMSTOCK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 WINSTED RD
Mailing Address - Street 2:WCMHN-TORRINGTON
Mailing Address - City:TORRINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06790-2958
Mailing Address - Country:US
Mailing Address - Phone:860-496-3779
Mailing Address - Fax:860-496-3868
Practice Address - Street 1:249 WINSTED RD
Practice Address - Street 2:WCMHN-TORRINGTON
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-2958
Practice Address - Country:US
Practice Address - Phone:860-496-3779
Practice Address - Fax:860-496-3868
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002949103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical