Provider Demographics
NPI:1225259880
Name:HOCHSTEDLER, DELTON VAUGHN (ISW)
Entity Type:Individual
Prefix:MR
First Name:DELTON
Middle Name:VAUGHN
Last Name:HOCHSTEDLER
Suffix:
Gender:M
Credentials:ISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 E. HIGH ST.
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140
Mailing Address - Country:US
Mailing Address - Phone:740-852-0922
Mailing Address - Fax:
Practice Address - Street 1:1150 SCIOTO ST.
Practice Address - Street 2:STE. 200
Practice Address - City:URBANA
Practice Address - State:OH
Practice Address - Zip Code:43078
Practice Address - Country:US
Practice Address - Phone:937-652-4555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.00299471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical