Provider Demographics
NPI:1225745482
Name:MUHAMMAD, TERRANCE L
Entity Type:Individual
Prefix:MR
First Name:TERRANCE
Middle Name:L
Last Name:MUHAMMAD
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:TERRANCE
Other - Middle Name:L
Other - Last Name:MINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2306 TRAYMORE PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-1854
Mailing Address - Country:US
Mailing Address - Phone:614-753-7104
Mailing Address - Fax:
Practice Address - Street 1:2306 TRAYMORE PL
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-1854
Practice Address - Country:US
Practice Address - Phone:614-753-7104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-27
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst