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1003533423
ALTAGRACE K SOUVERAIN
CLERMONT, FL
NPI
1003533423
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW20568)
Enumeration Date
2022-10-26
Last Update Date
2022-10-26
Business Address
ALTAGRACE K SOUVERAIN LCSW
2140 N DON WICKHAM DR
CLERMONT, FL 34711-1922
Phone number: 352-394-5922
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Mailing Address
ALTAGRACE K SOUVERAIN LCSW
PO BOX 491000
LEESBURG, FL 34749-1000
Phone number: 352-315-7500
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