Provider Demographics
NPI:1306421755
Name:PEDIGO, ALANA
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:
Last Name:PEDIGO
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 1:1302 BROCKTON DR
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-8846
Mailing Address - Country:US
Mailing Address - Phone:443-340-6959
Mailing Address - Fax:
Practice Address - Street 1:1302 BROCKTON DR
Practice Address - Street 2:
Practice Address - City:ELDERSBURG
Practice Address - State:MD
Practice Address - Zip Code:21784-8846
Practice Address - Country:US
Practice Address - Phone:443-340-6959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-16
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD181731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical