| Doctor Name: | DR. MEGAN ELIZABETH SULLAWAY |
| NPI Number: | 1184730178 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY9947 |
| Business Practice Address: | 877 N Douglas St El Segundo, CA - 902452801 |
| Business Phone Number: | 3105360211 |
| Business Fax Number: | 3105360215 |
| Mailing Address: | 877 N Douglas St, EL SEGUNDO |
| State: | CA |
| Postal Code: | 902452801 |
| Phone Number: | 3105360211 |
| Fax Number: | 3105360215 |
| NPI Enumeration Date: | 08/22/2006 |
| NPI Last Update Date: | 02/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY9947 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |