Provider Demographics
NPI:1700365061
Name:DELOTELLE, STEVE GUTHERIE (MA)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:GUTHERIE
Last Name:DELOTELLE
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:STEVE
Other - Middle Name:GUTHERIE
Other - Last Name:DELOTELLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6142 BITTERSWEET LN
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:TN
Mailing Address - Zip Code:37353-2201
Mailing Address - Country:US
Mailing Address - Phone:423-710-5977
Mailing Address - Fax:
Practice Address - Street 1:6110 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1894
Practice Address - Country:US
Practice Address - Phone:423-509-4128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health