Individual
MR. AGUSTIN GRACIA III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
50 W STRAWBRIDGE AVE, MELBOURNE, FL 32901-4438
(321) 952-5482
Mailing address
1100 PINE CREEK CIR NE, PALM BAY, FL 32905-4719
(954) 243-3813
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW20112
FL
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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