Provider Demographics
NPI:1578957692
Name:KRENKLER, MARIAM S (OTR/L)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:S
Last Name:KRENKLER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MARIAM
Other - Middle Name:I
Other - Last Name:CHINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1047 WAYFARER LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-8424
Mailing Address - Country:US
Mailing Address - Phone:804-477-4276
Mailing Address - Fax:
Practice Address - Street 1:4105 FABER PLACE DR STE 420
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8594
Practice Address - Country:US
Practice Address - Phone:843-894-7374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4857225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist