MEDICARE: SANDY HYATT PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	1578	LA

General Provider Information

NPI Number	:	1356876189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDY HYATT PSYD

Provider Business Mailing Address
First Line	:	13125 HIGHWAY 44
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-6812
Country	:	US
Telephone Number	:	225-202-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 TULANE AVE RM 235L-1
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2865
Country	:	US
Telephone Number	:	504-903-9213
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2017
Last Update Date	:	06/08/2026

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Directions to “ SANDY HYATT PSYD” Practice Location

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