Provider Demographics
NPI:1689239246
Name:RAHIM, JAMILAH (BCBA)
Entity Type:Individual
Prefix:
First Name:JAMILAH
Middle Name:
Last Name:RAHIM
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 MID LN APT 1606
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-4308
Mailing Address - Country:US
Mailing Address - Phone:312-912-1901
Mailing Address - Fax:
Practice Address - Street 1:2311 MID LN APT 1606
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-4308
Practice Address - Country:US
Practice Address - Phone:312-912-1901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2802103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst