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1154137081
LAURA ELAINE SOUTHGATE
SANFORD, FL
NPI
1154137081
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2024-12-05
Last Update Date
2024-12-05
Business Address
LAURA ELAINE SOUTHGATE MCAP
211 ESLINGER WAY
SANFORD, FL 32773-6188
Phone number: 407-775-6106
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Mailing Address
LAURA ELAINE SOUTHGATE MCAP
800 HANOVER RD
DELAND, FL 32724-8313
Phone number: 319-329-5336
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