Individual
ALEXANDER A BLYTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1104 ISABEL DR, ALGONQUIN, IL 60102-3510
(815) 355-6026
Mailing address
1104 ISABEL DR, ALGONQUIN, IL 60102-3510
(815) 355-6026
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-78078
IL
Other
Enumeration date
03/29/2020
Last updated
12/26/2024
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