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Organization

MIND SHIFT WELLNESS CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH MUTEGYEKI PMHNP-BC (DIRECTOR)
(508) 306-1128
Entity
Organization

Contact information

Practice address
31 GRANITE ST STE 2, MILFORD, MA 01757-1695
(508) 933-1804
Mailing address
31 GRANITE ST STE 2, MILFORD, MA 01757-1695
(508) 306-1128

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
03/26/2026
Last updated
03/26/2026
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