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Organization
SOUL TIES BEHAVIORAL THERAPY INC.
Active
Organization
SOUL TIES BEHAVIORAL THERAPY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYASIA WILLIAMS SMITH (OWNER)
(818) 916-2762
Entity
Organization
Contact information
Practice address
4075 PARK BLVD APT 504, SAN DIEGO, CA 92103-2671
(818) 916-2762
Mailing address
4075 PARK BLVD APT 504, SAN DIEGO, CA 92103-2671
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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