Provider Demographics
NPI:1457000606
Name:COMER, REGAN M
Entity Type:Individual
Prefix:
First Name:REGAN
Middle Name:M
Last Name:COMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 E MARTINSBURG FIRE RD
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:IN
Mailing Address - Zip Code:47164-6927
Mailing Address - Country:US
Mailing Address - Phone:812-972-3526
Mailing Address - Fax:
Practice Address - Street 1:7509 CHARLESTOWN PIKE
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-9623
Practice Address - Country:US
Practice Address - Phone:812-669-0462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)