Provider Demographics
NPI:1497223747
Name:SPELIOTIS, ADERONKE
Entity Type:Individual
Prefix:
First Name:ADERONKE
Middle Name:
Last Name:SPELIOTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:
Other - Last Name:SPELIOTIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5301 WILLIAMSON RD STE B
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-1449
Mailing Address - Country:US
Mailing Address - Phone:540-988-6634
Mailing Address - Fax:
Practice Address - Street 1:5301 WILLIAMSON RD STE B
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-1449
Practice Address - Country:US
Practice Address - Phone:540-988-6634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician