Individual provider · Type 1 NPI

Keisha Formanek, COTA/L

Occupational Therapy Assistant · West Union, IA

NPI number 1073322103 Active

Practice location

112 Jefferson St
West Union, IA 52175-1022

Call (563) 422-3811 Map

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X080424 (IA)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1073322103

Keisha Formanek, COTA/L's National Provider Identifier is 1073322103, issued on Jan 3, 2025. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in West Union, IA. The record was last updated on Jan 3, 2025.