Blaine Larsen

NPI #1447546353 in Moroni, Utah

Provider Information

NPI Number: 1447546353
Entity Type: Individual
Name: Blaine Larsen
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Jun 20, 2011
Last Updated: Jun 20, 2011

Practice Location

Address: 21260 N 1450 E
City: Moroni
State: Utah
ZIP Code: 84646-0461
Phone: (435) 445-5200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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