Provider Demographics
NPI:1831780378
Name:HAIGHT, AMY KATHRYN (OTD)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:KATHRYN
Last Name:HAIGHT
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BEACON CT
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-8435
Mailing Address - Country:US
Mailing Address - Phone:615-426-6012
Mailing Address - Fax:
Practice Address - Street 1:104 BEACON CT
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-8435
Practice Address - Country:US
Practice Address - Phone:615-426-6012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4745225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist