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Organization

MI MC SPROUT 1 LLC

Active
Other names
Elemy, Sprout Therapy, Tilly
Organization subpart
No

Provider details

NPI number
Authorized official
YURY YAKUBCHYK MD (OWNER)
(833) 991-2368
Entity
Organization

Contact information

Practice address
100 W BIG BEAVER RD STE 200, TROY, MI 48084-5283
(833) 991-2368
(929) 384-7193
Mailing address
100 W BIG BEAVER RD STE 200, TROY, MI 48084-5283
(833) 991-2368
(929) 384-7193

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
03/16/2021
Last updated
06/24/2025
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