Provider Demographics
NPI:1821252495
Name:MISHRA, JASLEEN (PT, MS)
Entity Type:Individual
Prefix:MRS
First Name:JASLEEN
Middle Name:
Last Name:MISHRA
Suffix:
Gender:F
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13505 CLEVELAND DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3606
Mailing Address - Country:US
Mailing Address - Phone:240-346-1488
Mailing Address - Fax:
Practice Address - Street 1:3202 TOWER OAKS BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4219
Practice Address - Country:US
Practice Address - Phone:301-231-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT8705222251N0400X
MD227182251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology