Provider Demographics
NPI:1427713965
Name:BEEKS-GIBSON, TASHA (OTR/L)
Entity type:Individual
Prefix:
First Name:TASHA
Middle Name:
Last Name:BEEKS-GIBSON
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 PIERCE LN
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-1302
Mailing Address - Country:US
Mailing Address - Phone:864-901-4450
Mailing Address - Fax:
Practice Address - Street 1:104 PIERCE LN
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-1302
Practice Address - Country:US
Practice Address - Phone:864-900-4450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-31
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6336225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist