Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1508129461 |
---|---|
Provider Name | Jason Andrew Haight |
First Address | Fort Worth, TX 76135-2534 |
Second Address | Fort Worth, TX 76135-2534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2012 |
Last Update Date | 15/06/2012 |