| Sprout Therapy | |
|
1775 Tysons Blvd Fl 5 Mc Lean VA 22102-4285 | |
| (786) 210-8200 | |
| Not Available |
| Full Name | Sprout Therapy |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1775 Tysons Blvd Fl 5, Mc Lean, Virginia |
| Authorized Official Name and Position | Yury Yakubchyk (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7862108200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sprout Therapy 1775 Tysons Blvd Fl 5 Mc Lean VA 22102-4285 Ph: (786) 210-8200 | Sprout Therapy 1775 Tysons Blvd Fl 5 Mc Lean VA 22102-4285 Ph: (786) 210-8200 |
| NPI Number | 1356975494 |
|---|---|
| Provider Enumeration Date | 02/27/2020 |
| Last Update Date | 09/27/2021 |
| Certification Date | 09/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356975494 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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