Healthcare Provider Details

I. General information

NPI: 1154789113
Provider Name (Legal Business Name): DESIREE RIOS POLL PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 891 BARRIO KM 15.1
COROZAL PR
00783
US

IV. Provider business mailing address

PO BOX 515
NARANJITO PR
00719-0515
US

V. Phone/Fax

Practice location:
  • Phone: 787-869-5900
  • Fax:
Mailing address:
  • Phone: 787-859-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number8519
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number4342
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: