Dominique Young-Fomby

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

5039 Villa Vinde Parkway
Suite #30
Flint, MI 48532

Phone

(989) 401-2244

NPI assigned

Dec 19, 2022

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1780396044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 VILLA VINDE PARKWAY",
            "address_2": "SUITE #30",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "989-401-2244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5039 VILLA VINDE PARKWAY",
            "address_2": "SUITE #30",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "48532",
            "telephone_number": "989-401-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG-FOMBY",
        "first_name": "DOMINIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devyn York
• Shawn A York, DDS
• Amy Yorke, PT, PHD, NCS
• You Overcoming Lactation Obstacles
• Young Life Wellness
• Andrea Leigh Young, PA-C
• Carol Young, LMSW
• Edward Young
• Katelyn Young
• Kayley Marie Young, PTA

• Behavior Technician in Flint, MI
• Providers in Flint, MI by specialty
• Behavior Technician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.