Staunton Mc 1 LLC

NPI #1356975494 in Mc Lean, Virginia

Provider Information

NPI Number: 1356975494
Entity Type: Organization
Organization Name: Staunton Mc 1 LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Feb 27, 2020
Last Updated: Sep 27, 2021

Practice Location

Address: 1775 TYSONS BLVD FL 5
City: Mc Lean
State: Virginia
ZIP Code: 22102-4285
Phone: (786) 210-8200

Authorized Official

Name: YURY YAKUBCHYK SR., MD
Title: MEDICAL DIRECTOR
Phone: (786) 210-8200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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