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1124751441
BLAINE KEATON DAIMARU
SOUTH JORDAN, UT
NPI
1124751441
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: UT 11302959-3501)
Enumeration Date
2022-07-05
Last Update Date
2022-07-05
Business Address
BLAINE KEATON DAIMARU LCSW
11260 S RIVER HEIGHTS DR
SOUTH JORDAN, UT 84095-5119
Phone number: 801-298-2000
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Mailing Address
BLAINE KEATON DAIMARU LCSW
11260 S RIVER HEIGHTS DR
SOUTH JORDAN, UT 84095-5119
Phone number: 801-298-2000
Copy
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