Provider Demographics
NPI:1215112461
Name:LAGUANA, DIONE MARIE INOCENTES (MA, LMHC)
Entity type:Individual
Prefix:MRS
First Name:DIONE MARIE
Middle Name:INOCENTES
Last Name:LAGUANA
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MS
Other - First Name:DIONE MARIE
Other - Middle Name:BORJA
Other - Last Name:INOCENTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:418 CARPENTER RD SE STE 104
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-7905
Mailing Address - Country:US
Mailing Address - Phone:360-402-1962
Mailing Address - Fax:360-890-4099
Practice Address - Street 1:418 CARPENTER RD SE STE 104
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-7905
Practice Address - Country:US
Practice Address - Phone:360-402-1962
Practice Address - Fax:360-628-8774
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00060182101YM0800X
WALH 60256528101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health