Provider Demographics
NPI:1710194451
Name:KLEPPE-BACH, RENEE LYNN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:LYNN
Last Name:KLEPPE-BACH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 WILLOWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-8859
Mailing Address - Country:US
Mailing Address - Phone:803-454-9032
Mailing Address - Fax:
Practice Address - Street 1:609 WILLOWOOD PKWY
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-8859
Practice Address - Country:US
Practice Address - Phone:803-454-9032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2954225X00000X
OH002374225XP0200X
AZ5957225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist