Provider Demographics
NPI:1194693242
Name:BINKLEY, SUSAN K (LMT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:BINKLEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:TX
Mailing Address - Zip Code:76574-2871
Mailing Address - Country:US
Mailing Address - Phone:512-887-8413
Mailing Address - Fax:
Practice Address - Street 1:1102 S ROCK ST STE 1
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6750
Practice Address - Country:US
Practice Address - Phone:512-887-8413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT119362225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist