Provider Demographics
NPI:1396224267
Name:CHIACCIO, ROBERT PAUL (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PAUL
Last Name:CHIACCIO
Suffix:
Gender:M
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 HAMPTON PL
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48604-9284
Mailing Address - Country:US
Mailing Address - Phone:989-220-8089
Mailing Address - Fax:
Practice Address - Street 1:5451 HAMPTON PL
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48604-9284
Practice Address - Country:US
Practice Address - Phone:989-220-8089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MI7401001141103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician