Individual
JISHA JAPAGNANAM MULLONKAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS. CCC-SLP
Contact information
Practice address
9701 VEIRS DR, ROCKVILLE, MD 20850-3414
(240) 394-2543
Mailing address
15 LEATHERLEAF CT, GAITHERSBURG, MD 20878-2659
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
08698
MD
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
01/17/2018
Last updated
07/17/2019
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