Provider Demographics
NPI:1275033326
Name:RADLO, ANNE-ALYCE EDINGER (BCBA)
Entity type:Individual
Prefix:
First Name:ANNE-ALYCE
Middle Name:EDINGER
Last Name:RADLO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ANNE-ALYCE
Other - Middle Name:
Other - Last Name:EDINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7277 S ALLISON WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4355
Mailing Address - Country:US
Mailing Address - Phone:210-355-9515
Mailing Address - Fax:
Practice Address - Street 1:6385 CORPORATE DR STE 200-41
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-5901
Practice Address - Country:US
Practice Address - Phone:719-341-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-15
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
18-48958103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst