Provider Demographics
NPI:1457977787
Name:BOGHARA, JANKI (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JANKI
Middle Name:
Last Name:BOGHARA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5012 DRUID DR
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1222
Mailing Address - Country:US
Mailing Address - Phone:215-237-8841
Mailing Address - Fax:
Practice Address - Street 1:1833 IRVING ST NW LOWR UNIT
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2614
Practice Address - Country:US
Practice Address - Phone:202-643-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSLP001309235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist