Provider Demographics
NPI:1508125675
Name:SPOONER, SARA
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:
Last Name:SPOONER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PARK PL
Mailing Address - Street 2:
Mailing Address - City:EAST TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02718-1583
Mailing Address - Country:US
Mailing Address - Phone:508-837-3094
Mailing Address - Fax:
Practice Address - Street 1:18 PARK PL
Practice Address - Street 2:
Practice Address - City:EAST TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02718-1583
Practice Address - Country:US
Practice Address - Phone:508-837-3094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst