Organization
AZ SPROUT MC 1 LLC
Active
Other names
Elemy, Tilly, Sprout Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
YURY YAKUBCHYK SR. (OWNER)
(480) 591-7312
Entity
Organization
Contact information
Practice address
2550 W UNION HILLS DR STE 350, PHOENIX, AZ 85027-5187
(833) 991-2368
(929) 384-7193
Mailing address
2550 W UNION HILLS DR STE 350, PHOENIX, AZ 85027-5187
(833) 991-2368
(929) 384-7193
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/16/2020
Last updated
06/24/2025
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