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NPI Code Detail

MEDICARE: GINA M DELGARDO PH.D.

MEDICARE: GINA M DELGARDO PH.D.
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
1103G00000XClinical Neuropsychologist2893TN
2103TC0700XClinical Psychologist2893TN
3103TH0100XHealth Service Psychologist2893TN
4103TF0200XForensic Psychologist2893TN
5103TR0400XRehabilitation Psychologist2893TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12893OTHERTNLICENSURE

General Provider Information

NPI Number : 1902028160
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA M DELGARDO PH.D.
Provider Business Mailing Address
First Line : PO BOX 4896
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37405-0896
Country : US
Telephone Number : 423-427-6822
Fax Number : 423-301-8985
Provider Business Practice Location Address
First Line : 200 W MARTIN LUTHER KING BLVD STE 1000
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37402-2571
Country : US
Telephone Number : 423-427-6822
Fax Number : 423-301-8985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2007
Last Update Date : 01/06/2026

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