Organization
TOTAL BEHAVIOR SUPPORT LLC
Active
Other names
Total Behavior Support
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA NICCOLE KORNELIS LBA (BCBA)
(707) 450-7587
Entity
Organization
Contact information
Practice address
1015 S BROADWAY STE 16, MINOT, ND 58701-4667
(707) 450-7587
Mailing address
1015 S BROADWAY STE 16, MINOT, ND 58701-4667
(707) 450-7587
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L78
BEHAVIOR ANALYST LICENSE
ND
Enumeration date
05/12/2021
Last updated
07/19/2021
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