Individual
MS. BLYTHE JUDITH HAMILTON MARUYAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
522 CHESTNUT ST STE 2D, HINSDALE, IL 60521-3173
(630) 321-1073
Mailing address
529 S ASHLAND AVE, LA GRANGE, IL 60525-2812
(773) 818-6570
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149015371
IL
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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