Provider Demographics
NPI:1457105504
Name:BEHAVIOR SHAPING SOLUTIONS
Entity Type:Organization
Organization Name:BEHAVIOR SHAPING SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED BEHAVIOR ANALYST
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIKONDI
Authorized Official - Middle Name:EDGAR
Authorized Official - Last Name:SAIWA
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:727-239-1209
Mailing Address - Street 1:127 BROOKHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:ELLERSLIE
Mailing Address - State:GA
Mailing Address - Zip Code:31807-6315
Mailing Address - Country:US
Mailing Address - Phone:172-723-9120
Mailing Address - Fax:706-243-5933
Practice Address - Street 1:127 BROOKHAVEN CT
Practice Address - Street 2:
Practice Address - City:ELLERSLIE
Practice Address - State:GA
Practice Address - Zip Code:31807-6315
Practice Address - Country:US
Practice Address - Phone:172-723-9120
Practice Address - Fax:706-243-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty