Provider Demographics
NPI:1568769388
Name:HITZKE, DEENA GAYLE (MA, EDD, LAC)
Entity Type:Individual
Prefix:DR
First Name:DEENA
Middle Name:GAYLE
Last Name:HITZKE
Suffix:
Gender:F
Credentials:MA, EDD, LAC
Other - Prefix:
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Mailing Address - Street 1:3855 E RYAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-2923
Mailing Address - Country:US
Mailing Address - Phone:520-325-8187
Mailing Address - Fax:520-624-6977
Practice Address - Street 1:1625 N ALVERNON WAY STE 101
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3370
Practice Address - Country:US
Practice Address - Phone:520-623-3341
Practice Address - Fax:520-623-9577
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-19587101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional