Provider Demographics
NPI:1538537618
Name:WESTRUM, MARLEE
Entity type:Individual
Prefix:
First Name:MARLEE
Middle Name:
Last Name:WESTRUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARLEE
Other - Middle Name:
Other - Last Name:WHEELHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3835 SUPREME CT NW
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-4446
Mailing Address - Country:US
Mailing Address - Phone:218-444-8280
Mailing Address - Fax:218-444-8337
Practice Address - Street 1:3835 SUPREME CT NW
Practice Address - Street 2:SUITE 2
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-4446
Practice Address - Country:US
Practice Address - Phone:218-444-8280
Practice Address - Fax:218-444-8337
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104954225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist