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General NPI Number Information
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NPI Number | 1992575880
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Entity Type | Organization
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Legal Business Name | MIGHTY MINDS MENTAL HEALTH
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Dates
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Enumeration Date | 01/03/2024
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 26 MILLYARD STE 7
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City | AMESBURY
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State | MA
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Zip | 01913-2429
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Country | US
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Telephone | 978-504-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 95 LOWELL RD
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City | WINDHAM
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State | NH
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Zip | 03087-1809
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Country | US
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Telephone | 133-920-6747
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Fax |
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Authorized Official
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Title or Position | CLINICIAN
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Name | ALEXANDRA KAYLA SHEPPARD
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Credential |
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Telephone | 339-206-7477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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