Healthcare Provider Details

I. General information

NPI: 1164863205
Provider Name (Legal Business Name): MONICA MUNOZ MAGALLAN M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. MONICA MUNOZ

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 10/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 N GREEN VALLEY PKWY STE 311
HENDERSON NV
89014-0412
US

IV. Provider business mailing address

1919 S JONES BLVD STE H
LAS VEGAS NV
89146-1299
US

V. Phone/Fax

Practice location:
  • Phone: 702-508-5920
  • Fax:
Mailing address:
  • Phone: 702-824-1924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMI0904
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: