Individual
DANIEL ALAN BLAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
4100 W 3RD ST, DAYTON, OH 45428-9000
(937) 268-6511
Mailing address
421 W BROADWAY ST, TIPP CITY, OH 45371-1642
(937) 286-8338
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1903339
OH
Other
Enumeration date
03/06/2019
Last updated
03/06/2019
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