MEDICARE: KATHRYN POGUE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	247200000X	Other Technician
3	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1770029712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN POGUE

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10751 S SAGINAW ST STE E
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-8169
Country	:	US
Telephone Number	:	586-404-9400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2017
Last Update Date	:	01/30/2025

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Directions to “ KATHRYN POGUE ” Practice Location

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