Provider Demographics
NPI:1841560885
Name:FORBUSH, MARLENE KAY (OTR)
Entity Type:Individual
Prefix:MS
First Name:MARLENE
Middle Name:KAY
Last Name:FORBUSH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:MARLENE
Other - Middle Name:KAY
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2448 S 102ND STREET SUITE 340
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53227-2141
Mailing Address - Country:US
Mailing Address - Phone:414-329-2500
Mailing Address - Fax:
Practice Address - Street 1:2448 S 102ND STREET SUITE 340
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53227-2141
Practice Address - Country:US
Practice Address - Phone:414-329-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3073-26225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation