Provider Demographics
NPI:1124567151
Name:AMAXOPOULOS, APOSTOLIS (PSYD)
Entity Type:Individual
Prefix:DR
First Name:APOSTOLIS
Middle Name:
Last Name:AMAXOPOULOS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 KEEAUMOKU ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-4310
Mailing Address - Country:US
Mailing Address - Phone:808-722-1270
Mailing Address - Fax:
Practice Address - Street 1:1608 KEEAUMOKU ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-4310
Practice Address - Country:US
Practice Address - Phone:808-722-1270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1644103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical