Provider Demographics
NPI:1821820911
Name:MUHAMMAD-WILKENSON, TAHIRAH JAMILYAH ABDULLAH
Entity type:Individual
Prefix:
First Name:TAHIRAH
Middle Name:JAMILYAH ABDULLAH
Last Name:MUHAMMAD-WILKENSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8440 EASTON COMMONS DR APT 115
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-3036
Mailing Address - Country:US
Mailing Address - Phone:832-881-3012
Mailing Address - Fax:
Practice Address - Street 1:2743 SMITH RANCH RD UNIT 1202
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5219
Practice Address - Country:US
Practice Address - Phone:832-598-2819
Practice Address - Fax:281-969-8711
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-24-347675106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician