Provider Demographics
NPI:1861413783
Name:MOONEY, HEATHER MAGALLON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:MAGALLON
Last Name:MOONEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:MAGALLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:975 KIRMAN AVE
Mailing Address - Street 2:(119)
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502
Mailing Address - Country:US
Mailing Address - Phone:775-326-2950
Mailing Address - Fax:
Practice Address - Street 1:975 KIRMAN AVE
Practice Address - Street 2:(119)
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-326-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ132321835P1200X, 1835P1300X
NV172681835P1300X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy