Provider Demographics
NPI:1790146934
Name:PEYTON, HEIDA MARIE
Entity Type:Individual
Prefix:MRS
First Name:HEIDA
Middle Name:MARIE
Last Name:PEYTON
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 1:4508 SE 21ST ST
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-4002
Mailing Address - Country:US
Mailing Address - Phone:310-438-8643
Mailing Address - Fax:
Practice Address - Street 1:744 SE 25TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73129-4843
Practice Address - Country:US
Practice Address - Phone:310-438-8643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst