Provider Demographics
NPI:1487481404
Name:RIOS MONTES, DIEMMYX EDGARDO (MPSY)
Entity type:Individual
Prefix:MR
First Name:DIEMMYX
Middle Name:EDGARDO
Last Name:RIOS MONTES
Suffix:
Gender:M
Credentials:MPSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 CALLE CIMA
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00730-4134
Mailing Address - Country:US
Mailing Address - Phone:787-618-4423
Mailing Address - Fax:
Practice Address - Street 1:1626 CALLE CIMA
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00730-4134
Practice Address - Country:US
Practice Address - Phone:787-618-4423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-14
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7239103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist