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Individual

ALEXANDRA BLAKEWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7351 GREAT HILL RD, CRYSTAL LAKE, IL 60012-1633
(815) 354-5511
Mailing address
7351 GREAT HILL RD, CRYSTAL LAKE, IL 60012-1633

Taxonomy

Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225A00000X
225A00000X
IL
Enumeration date
07/14/2017
Last updated
07/14/2017
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