Provider Demographics
NPI:1619780640
Name:DIGIOVANNI, HYDIE L HENSON (PSYD)
Entity type:Individual
Prefix:DR
First Name:HYDIE
Middle Name:L HENSON
Last Name:DIGIOVANNI
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 1:989 S MAIN ST STE A484
Mailing Address - Street 2:
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4601
Mailing Address - Country:US
Mailing Address - Phone:928-202-2406
Mailing Address - Fax:
Practice Address - Street 1:4015 E PUEBLO RD
Practice Address - Street 2:
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-5738
Practice Address - Country:US
Practice Address - Phone:928-202-2406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005541103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist