Provider Demographics
NPI:1982482410
Name:HALES, MACY MORGAN (RDN)
Entity type:Individual
Prefix:
First Name:MACY
Middle Name:MORGAN
Last Name:HALES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2165 E MINTON ST
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85213-1439
Mailing Address - Country:US
Mailing Address - Phone:480-652-6227
Mailing Address - Fax:
Practice Address - Street 1:1778 N 70 E APT B
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-3836
Practice Address - Country:US
Practice Address - Phone:480-652-6227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT86291135133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management