Provider Demographics
NPI:1255635025
Name:BINNING, LILA F
Entity type:Individual
Prefix:MRS
First Name:LILA
Middle Name:F
Last Name:BINNING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LILA
Other - Middle Name:
Other - Last Name:BALLENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 N MISSION LN
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-3909
Mailing Address - Country:US
Mailing Address - Phone:918-758-1930
Mailing Address - Fax:918-758-1920
Practice Address - Street 1:300 N MISSION LN
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-3909
Practice Address - Country:US
Practice Address - Phone:918-758-1930
Practice Address - Fax:918-758-1920
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OK101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor