Provider Demographics
NPI:1275094146
Name:ALEDO, ILEANA (MSED, BCBA, LBS)
Entity Type:Individual
Prefix:
First Name:ILEANA
Middle Name:
Last Name:ALEDO
Suffix:
Gender:F
Credentials:MSED, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 RACCOON RUN
Mailing Address - Street 2:
Mailing Address - City:EFFORT
Mailing Address - State:PA
Mailing Address - Zip Code:18330-7987
Mailing Address - Country:US
Mailing Address - Phone:646-265-9075
Mailing Address - Fax:
Practice Address - Street 1:117 RACCOON RUN
Practice Address - Street 2:
Practice Address - City:EFFORT
Practice Address - State:PA
Practice Address - Zip Code:18330-7987
Practice Address - Country:US
Practice Address - Phone:646-265-9075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst