Provider Demographics
NPI:1912201666
Name:REALI, ALAINA CLARK (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ALAINA
Middle Name:CLARK
Last Name:REALI
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MRS
Other - First Name:ALAINA
Other - Middle Name:CLARK
Other - Last Name:VALENTINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, BCBA
Mailing Address - Street 1:6940 W 109TH AVE APT N305
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80020-1670
Mailing Address - Country:US
Mailing Address - Phone:720-592-8243
Mailing Address - Fax:
Practice Address - Street 1:500 DISCOVERY PKWY STE 100
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8637
Practice Address - Country:US
Practice Address - Phone:720-647-8541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-07-3483103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO161264Medicaid