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General NPI Number Information
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NPI Number | 1609700749
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Entity Type | Organization
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Legal Business Name | ANNGENE ENTERPRISES INC.
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Dates
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Enumeration Date | 06/12/2026
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Last Update Date | 06/12/2026
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Provider Practice Location Address
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Address Line | 10 SURFSIDE AVE
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City | WINTHROP
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State | MA
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Zip | 02152-2537
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Country | US
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Telephone | 941-457-2380
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Fax |
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Provider Business Mailing Address
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Address Line | 111 BEDFORD DR NE
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City | PORT CHARLOTTE
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State | FL
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Zip | 33952-8106
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Country | US
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Telephone | 978-821-8160
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | KATHLEEN M MACDOUGALL
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Credential | LICSW
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Telephone | 978-821-8160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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