Provider Demographics
NPI:1669463238
Name:HAIGHT, EMILY SUZANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:SUZANNE
Last Name:HAIGHT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4059 CREST VIEW RD. NE
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:IA
Mailing Address - Zip Code:52333-9457
Mailing Address - Country:US
Mailing Address - Phone:708-717-4234
Mailing Address - Fax:708-687-8120
Practice Address - Street 1:4059 CREST VIEW RD. NE
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-9457
Practice Address - Country:US
Practice Address - Phone:708-717-4234
Practice Address - Fax:708-687-8120
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-02
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-003992103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932221OtherBLUE CROSS/SHIELD PPO
IL209872Medicare ID - Type Unspecified