Provider Demographics
NPI:1467227728
Name:RADLOFF, SYDNEY NICOLE
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:NICOLE
Last Name:RADLOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 S RANCHO DR # 4-337
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3837
Mailing Address - Country:US
Mailing Address - Phone:702-440-8440
Mailing Address - Fax:
Practice Address - Street 1:526 S TONOPAH DR STE 200
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4013
Practice Address - Country:US
Practice Address - Phone:702-440-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician