Provider Demographics
NPI:1154507101
Name:MUHAMMAD, DEBORAH D (LMT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:D
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:D
Other - Last Name:GOSSAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:10355 HONEYTREE CT
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-4236
Mailing Address - Country:US
Mailing Address - Phone:909-224-1851
Mailing Address - Fax:
Practice Address - Street 1:10355 HONEYTREE CT
Practice Address - Street 2:
Practice Address - City:FOUNTAIN
Practice Address - State:CO
Practice Address - Zip Code:80817-4236
Practice Address - Country:US
Practice Address - Phone:909-224-1851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-20
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO130678225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1154507101Medicaid
CO1154507101Medicare UPIN
CO1154507101Medicaid
CO1154507101Medicare PIN
CO1154507101Medicare Oscar/Certification