Provider Demographics
NPI:1720627987
Name:DEMEO, MICHELE S (CPM, LMT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:S
Last Name:DEMEO
Suffix:
Gender:F
Credentials:CPM, LMT
Other - Prefix:
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:VARELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPM, LMT
Mailing Address - Street 1:2448 ROBINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43620-1025
Mailing Address - Country:US
Mailing Address - Phone:419-699-2799
Mailing Address - Fax:
Practice Address - Street 1:5166 MONROE ST STE 301
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3472
Practice Address - Country:US
Practice Address - Phone:419-699-2279
Practice Address - Fax:567-316-6456
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-04
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.012409225700000X
261QF0050X, 374J00000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty