Provider Demographics
NPI:1770263626
Name:DESHONG, HILARY LEA (PHD)
Entity type:Individual
Prefix:DR
First Name:HILARY
Middle Name:LEA
Last Name:DESHONG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 NICKLAUS LN APT 10
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-6639
Mailing Address - Country:US
Mailing Address - Phone:662-312-6610
Mailing Address - Fax:
Practice Address - Street 1:81 NICKLAUS LN APT 10
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-6639
Practice Address - Country:US
Practice Address - Phone:662-312-6610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS591033103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist