Provider Demographics
NPI:1730831215
Name:HIGHTREE-COMSTOCK, BOBBI JO
Entity type:Individual
Prefix:MS
First Name:BOBBI
Middle Name:JO
Last Name:HIGHTREE-COMSTOCK
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 1:5701 CHRISTY RD APT 2102
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-9791
Mailing Address - Country:US
Mailing Address - Phone:712-899-8149
Mailing Address - Fax:
Practice Address - Street 1:210 10TH ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:NE
Practice Address - Zip Code:68784-5013
Practice Address - Country:US
Practice Address - Phone:712-899-8149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-11-8423103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst