Individual
ANTONIO IGNACIO-DE DIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 CONTINENTAL PL, MOUNT VERNON, WA 98273-5633
(360) 755-6405
Mailing address
1216 S 13TH ST, MOUNT VERNON, WA 98274-5102
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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