Provider Demographics
NPI:1700633922
Name:GALLOWAY, MEGAN (AMFT)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 E TOPEKA ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1459
Mailing Address - Country:US
Mailing Address - Phone:213-268-5772
Mailing Address - Fax:
Practice Address - Street 1:107 S FAIR OAKS AVE STE 310
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-2012
Practice Address - Country:US
Practice Address - Phone:626-319-2287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT144859101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health