Provider Demographics
NPI:1134946171
Name:REVNAK, KARINA WEHKING
Entity type:Individual
Prefix:MRS
First Name:KARINA
Middle Name:WEHKING
Last Name:REVNAK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARINA
Other - Middle Name:LEE
Other - Last Name:WEHKING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:445 E DUBLIN GRANVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-3192
Mailing Address - Country:US
Mailing Address - Phone:614-844-6258
Mailing Address - Fax:
Practice Address - Street 1:690 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:ROSSFORD
Practice Address - State:OH
Practice Address - Zip Code:43460-1221
Practice Address - Country:US
Practice Address - Phone:614-844-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician