Provider Demographics
NPI:1225826209
Name:COLBERT, DOMINIQUE YVETTE
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:YVETTE
Last Name:COLBERT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 W MCDOWELL RD APT 231
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-4676
Mailing Address - Country:US
Mailing Address - Phone:480-670-7905
Mailing Address - Fax:
Practice Address - Street 1:7021 W MCDOWELL RD APT 231
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-4676
Practice Address - Country:US
Practice Address - Phone:480-670-7905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst