Individual
LAURA ELAINE SOUTHGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCAP
Contact information
Practice address
211 ESLINGER WAY, SANFORD, FL 32773-6188
(407) 775-6106
Mailing address
800 HANOVER RD, DELAND, FL 32724-8313
(319) 329-5336
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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