Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Keisha Formanek, COTA/L

Individual provider Occupational Therapy Assistant · NPI 1073322103

Keisha Formanek, COTA/L is an Occupational Therapy Assistant in West Union, Iowa. Licensed in Iowa. Registered with an NPI since 2025.

Licensed in
IA
In the registry since
2025
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

112 Jefferson St
West Union, IA 52175-1022
Phone: (563) 422-3811
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 080424 (IA)

Record details

NPI number1073322103
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA/L
Sole proprietorNo
NPI enumeratedJanuary 3, 2025
Last updated in NPPESJanuary 3, 2025
Certification dateJanuary 3, 2025

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