Provider Demographics
NPI:1508129461
Name:HAIGHT, JASON ANDREW
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ANDREW
Last Name:HAIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAKE
Other - Middle Name:
Other - Last Name:HAIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4716 BARNHILL LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-2534
Mailing Address - Country:US
Mailing Address - Phone:817-909-8798
Mailing Address - Fax:
Practice Address - Street 1:4716 BARNHILL LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-2534
Practice Address - Country:US
Practice Address - Phone:817-909-8798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider