Provider Demographics
NPI:1932487980
Name:PEDEGO, ALI ELIZABETH (PHD, BCBA-D)
Entity type:Individual
Prefix:MS
First Name:ALI
Middle Name:ELIZABETH
Last Name:PEDEGO
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19153
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97280-0153
Mailing Address - Country:US
Mailing Address - Phone:781-999-1655
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 19153
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97280-0153
Practice Address - Country:US
Practice Address - Phone:781-999-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-06-2775103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst