Healthcare Provider Details

I. General information

NPI: 1821677782
Provider Name (Legal Business Name): RENEE GLUCHOWSKI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 JOHNNIE DODDS BLVD STE G
MT PLEASANT SC
29464-3100
US

IV. Provider business mailing address

508 LAUREL CT
EXETER PA
18643-1140
US

V. Phone/Fax

Practice location:
  • Phone: 843-654-9694
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number6780
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC017288
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: