Provider Demographics
NPI:1245367747
Name:COMSTOCK, ANITA LUCERO (GUIDANCE COUNSELOR K)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:LUCERO
Last Name:COMSTOCK
Suffix:
Gender:F
Credentials:GUIDANCE COUNSELOR K
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 PALMCROFT DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364
Mailing Address - Country:US
Mailing Address - Phone:928-502-8004
Mailing Address - Fax:928-502-4445
Practice Address - Street 1:2851 S AVENUE B BLDG 20
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7726
Practice Address - Country:US
Practice Address - Phone:928-336-2434
Practice Address - Fax:928-336-2435
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15552101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional