Provider Demographics
NPI:1801468632
Name:DEMEO, ANGELIQUE (DPT)
Entity type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:
Last Name:DEMEO
Suffix:
Gender:
Credentials:DPT
Other - Prefix:MRS
Other - First Name:ANGELIQUE
Other - Middle Name:
Other - Last Name:LAKATOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:357 WINDIGROVE DR APT 811
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-7494
Mailing Address - Country:US
Mailing Address - Phone:718-689-4677
Mailing Address - Fax:
Practice Address - Street 1:1102 ROSE HILL DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5128
Practice Address - Country:US
Practice Address - Phone:434-979-8628
Practice Address - Fax:434-979-8536
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214573225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist