Provider Demographics
NPI:1609431725
Name:REHKLAU, DIANE LYLNN
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:LYLNN
Last Name:REHKLAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 LINDEN ST
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:OH
Mailing Address - Zip Code:43543-1824
Mailing Address - Country:US
Mailing Address - Phone:419-451-8735
Mailing Address - Fax:
Practice Address - Street 1:10551 COUNTY ROAD K
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:OH
Practice Address - Zip Code:43543-9793
Practice Address - Country:US
Practice Address - Phone:419-451-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging