Healthcare Provider Details

I. General information

NPI: 1851204390
Provider Name (Legal Business Name): GREIXIOMARIE K ACOSTA RIVERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR. 695 KM 2.0 BO HIGUILLAR
DORADO PR
00646-4603
US

IV. Provider business mailing address

PO BOX 2200
ARECIBO PR
00613-2200
US

V. Phone/Fax

Practice location:
  • Phone: 939-545-5241
  • Fax:
Mailing address:
  • Phone: 787-604-5744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number008969
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: