Provider Demographics
NPI:1649053000
Name:HUFF, ETHAN
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:
Last Name:HUFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 HOLLISTER CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-7837
Mailing Address - Country:US
Mailing Address - Phone:314-287-1825
Mailing Address - Fax:314-338-4159
Practice Address - Street 1:94 HOLLISTER CT
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-7837
Practice Address - Country:US
Practice Address - Phone:314-287-1825
Practice Address - Fax:314-338-4159
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst