Provider Demographics
NPI:1215380647
Name:MUHAMMAD, JAMIL
Entity Type:Individual
Prefix:MR
First Name:JAMIL
Middle Name:
Last Name:MUHAMMAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7319 W MAGDALENA LN
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-3405
Mailing Address - Country:US
Mailing Address - Phone:602-920-6312
Mailing Address - Fax:
Practice Address - Street 1:7319 W MAGDALENA LN
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-3405
Practice Address - Country:US
Practice Address - Phone:602-920-6312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst