Provider Demographics
NPI:1285019117
Name:BINKLEY, MARY ANNE (PT)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ANNE
Last Name:BINKLEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:ANNE
Other - Last Name:CORLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1603 HIGH HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-4826
Mailing Address - Country:US
Mailing Address - Phone:407-877-6515
Mailing Address - Fax:
Practice Address - Street 1:1603 HIGH HAMPTON CT
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-4826
Practice Address - Country:US
Practice Address - Phone:407-877-6515
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 10970225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist