Organization
OH SPROUT MC 1 LLC
Active
Other names
Elemy, Sprout Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
YURY YAKUBCHYK SR. (OWNER)
(513) 854-4642
Entity
Organization
Contact information
Practice address
300 E BUSINESS WAY STE 200, CINCINNATI, OH 45241-2389
(626) 699-0236
(929) 384-7193
Mailing address
6303 BLUE LAGOON DR STE 400, MIAMI, FL 33126-6040
(626) 699-0236
(929) 384-7193
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
11/05/2021
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