Individual
BLAINE KEATON DAIMARU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1218 E 7800 S STE 210, SANDY, UT 84094-7228
(480) 687-3435
Mailing address
1218 E 7800 S STE 210, SANDY, UT 84094-7228
(480) 687-3435
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11302959-3501
UT
1041C0700X
Clinical Social Worker
5471460
ID
1041C0700X
Clinical Social Worker
LCSW-23132
AZ
Other
Enumeration date
07/05/2022
Last updated
02/09/2026
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