Provider Demographics
NPI:1437884202
Name:WAHLIN, RENEE (DPT)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:WAHLIN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:PAQUETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3575D MAYBANK HWY # 235
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-4823
Mailing Address - Country:US
Mailing Address - Phone:843-900-6202
Mailing Address - Fax:843-574-8858
Practice Address - Street 1:2052 RIVER RD STE E
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-8805
Practice Address - Country:US
Practice Address - Phone:843-900-6202
Practice Address - Fax:843-574-8858
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305215103225100000X
SC11381225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist