Provider Demographics
NPI:1073009411
Name:CHRISTIE, DEBANIA ALFREDA (CLMT)
Entity Type:Individual
Prefix:MS
First Name:DEBANIA
Middle Name:ALFREDA
Last Name:CHRISTIE
Suffix:
Gender:F
Credentials:CLMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 S ALTON WAY UNIT 1A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-1803
Mailing Address - Country:US
Mailing Address - Phone:720-209-8774
Mailing Address - Fax:
Practice Address - Street 1:3000 S JAMAICA CT STE 250
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80014-4605
Practice Address - Country:US
Practice Address - Phone:720-688-0293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0017906225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist