Provider Demographics
NPI:1922771716
Name:SPOOR, PAYTON
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:
Last Name:SPOOR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PAYTON
Other - Middle Name:
Other - Last Name:HOOTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:651 BLARNEY DR
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-6432
Mailing Address - Country:US
Mailing Address - Phone:463-215-9298
Mailing Address - Fax:
Practice Address - Street 1:651 BLARNEY DR
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064-6432
Practice Address - Country:US
Practice Address - Phone:463-215-9298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst