Provider Demographics
NPI:1063845030
Name:RAHIM-GIBSON, TAHEERAH BAHEEJAH (RRT)
Entity Type:Individual
Prefix:MRS
First Name:TAHEERAH
Middle Name:BAHEEJAH
Last Name:RAHIM-GIBSON
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5463 MCCULLOUGH DR APT C
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80902-1679
Mailing Address - Country:US
Mailing Address - Phone:808-227-1808
Mailing Address - Fax:
Practice Address - Street 1:5463 MCCULLOUGH DR APT C
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80902-1679
Practice Address - Country:US
Practice Address - Phone:808-227-1808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI103K00000X
TN5626227900000X
HIRT-574227900000X
CORTL0005361227900000X
HIRBT-16-21790247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other