Provider Demographics
NPI:1336655778
Name:GALLIGAN, MEGAN (BCBA, PHD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GALLIGAN
Suffix:
Gender:F
Credentials:BCBA, PHD
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:
Other - Last Name:LEDOUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4383 42ND ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1117
Mailing Address - Country:US
Mailing Address - Phone:800-538-8365
Mailing Address - Fax:
Practice Address - Street 1:9245 SKY PARK CT STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4311
Practice Address - Country:US
Practice Address - Phone:703-401-1967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-21
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA1-18-29450103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician