Healthcare Provider Details

I. General information

NPI: 1346781283
Provider Name (Legal Business Name): RR PSYCH PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2017
Last Update Date: 01/24/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE MUNOZ RIVERA 2 STE 309 CENTRO MEDICO PROFESIONAL
CAGUAS PR
00726-2604
US

IV. Provider business mailing address

316 CALLE SAN MATEO
JUNCOS PR
00777-8634
US

V. Phone/Fax

Practice location:
  • Phone: 787-612-7997
  • Fax:
Mailing address:
  • Phone: 787-612-7997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. DENNIS RIOS ROMAN
Title or Position: OWNER
Credential: PSYD
Phone: 787-612-7997