Provider Demographics
NPI:1659083673
Name:SOTO BEHAVIOR THERAPY INC
Entity Type:Organization
Organization Name:SOTO BEHAVIOR THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SOTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-300-8763
Mailing Address - Street 1:14980 SW 49TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4460
Mailing Address - Country:US
Mailing Address - Phone:305-300-8763
Mailing Address - Fax:
Practice Address - Street 1:14980 SW 49TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-4460
Practice Address - Country:US
Practice Address - Phone:305-300-8763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty