Provider Demographics
NPI:1235432469
Name:SAIWA, CHIKONDI EDGAR (BCBA)
Entity Type:Individual
Prefix:DR
First Name:CHIKONDI
Middle Name:EDGAR
Last Name:SAIWA
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:DR
Other - First Name:CHIKONDI
Other - Middle Name:EDGAR
Other - Last Name:SAIWA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CHIKO EDD,BCBA
Mailing Address - Street 1:189 MUSTANG TRL
Mailing Address - Street 2:
Mailing Address - City:WAVERLY HALL
Mailing Address - State:GA
Mailing Address - Zip Code:31831-2466
Mailing Address - Country:US
Mailing Address - Phone:727-239-1209
Mailing Address - Fax:
Practice Address - Street 1:189 MUSTANG TRL
Practice Address - Street 2:
Practice Address - City:WAVERLY HALL
Practice Address - State:GA
Practice Address - Zip Code:31831-2466
Practice Address - Country:US
Practice Address - Phone:727-239-1209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-13-13892103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst