Individual
BLAKE ANDREW MATHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
644 HAWLEY DR, OSWEGO, IL 60543-4070
(630) 204-0473
Mailing address
644 HAWLEY DR, OSWEGO, IL 60543-4070
(630) 204-0473
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149015436
IL
Other
Enumeration date
02/17/2009
Last updated
08/04/2020
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