Provider Demographics
NPI:1740797794
Name:SKOPOS, ALEXIS KATHOLIKI-ELENI (BA)
Entity Type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:KATHOLIKI-ELENI
Last Name:SKOPOS
Suffix:
Gender:F
Credentials:BA
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Mailing Address - Street 1:146 E VOORHIS AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-5951
Mailing Address - Country:US
Mailing Address - Phone:330-980-0751
Mailing Address - Fax:
Practice Address - Street 1:1823 BUSINESS PARK BLVD
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-1230
Practice Address - Country:US
Practice Address - Phone:386-254-1931
Practice Address - Fax:386-255-5818
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2017-12-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)