Jisha Japagnanam Mullonkal, MS. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

08698 Issued in MD

Practice address

9701 Veirs Dr
Rockville, MD 20850-3414

Phone

(240) 394-2543

NPI assigned

Jan 17, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1215445812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LEATHERLEAF CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 VEIRS DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503414",
            "telephone_number": "240-394-2543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1739 Kirby Rd",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221014817",
            "country_code": "US",
            "telephone_number": "571-297-6874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLONKAL",
        "first_name": "JISHA",
        "middle_name": "JAPAGNANAM",
        "credential": "MS. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "08698",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Mullen, D.C.
• Dale Denaburg Muller, OTR/L
• Terrence Mulligan, DO,MPH
• Ashley Mullins
• Camryn Mullins
• Multidisciplinary Pain Center
• Sean William Mulvaney, M.D.
• Erica Mulvany
• Ndyia Sabre Mulzac
• Donna Mumma

• Speech-Language Pathologist in Rockville, MD
• Providers in Rockville, MD by specialty
• Speech-Language Pathologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.