Provider Demographics
NPI:1306299011
Name:TRONTVET, TOBY (BCBA)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:
Last Name:TRONTVET
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-7520
Mailing Address - Country:US
Mailing Address - Phone:701-491-2510
Mailing Address - Fax:
Practice Address - Street 1:2520 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-7520
Practice Address - Country:US
Practice Address - Phone:701-491-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL16103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst