Provider Demographics
NPI:1437013513
Name:HAIGH, ETHAN JAMES
Entity type:Individual
Prefix:
First Name:ETHAN
Middle Name:JAMES
Last Name:HAIGH
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 1:14863 CHATHAM COURT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415
Mailing Address - Country:US
Mailing Address - Phone:484-502-4478
Mailing Address - Fax:
Practice Address - Street 1:7376 LAKE WORTH RD
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2529
Practice Address - Country:US
Practice Address - Phone:561-788-4086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-12
Last Update Date:2025-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-1377816106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician