MEDICARE: GINA DELGARDO PHD BEHAVIORAL MEDICINE AND FORENSIC SERVICES PLL

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TF0200X	Forensic Psychologist
2	103G00000X	Clinical Neuropsychologist
3	103TH0100X	Health Service Psychologist

General Provider Information

NPI Number	:	1891557104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GINA DELGARDO PHD BEHAVIORAL MEDICINE AND FORENSIC SERVICES PLL

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	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GINA DELGARDO
Credential	:	PH.D.
Telephone Number	:	423-427-6822

Provider Enumeration Date	:	01/23/2024
Last Update Date	:	01/06/2026

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