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General NPI Number Information
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NPI Number | 1619780640
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Entity Type | Individual
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Provider Name | HYDIE L. HENSON DIGIOVANNI PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 4015 E PUEBLO RD
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City | COTTONWOOD
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State | AZ
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Zip | 86326-5738
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Country | US
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Telephone | 928-202-2406
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Fax |
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Provider Business Mailing Address
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Address Line | 989 S MAIN ST STE A484
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City | COTTONWOOD
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State | AZ
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Zip | 86326-4601
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Country | US
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Telephone | 928-202-2406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-005541
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License Number State | AZ
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