Provider Demographics
NPI:1740903806
Name:HARRELL, DEBORAH PAULA (MA)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:PAULA
Last Name:HARRELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 352
Mailing Address - Street 2:
Mailing Address - City:WINTERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28590-0352
Mailing Address - Country:US
Mailing Address - Phone:252-524-1880
Mailing Address - Fax:
Practice Address - Street 1:4460 GREENBRIAR VILLAGE DRIVE
Practice Address - Street 2:APT D
Practice Address - City:AYDEN
Practice Address - State:NC
Practice Address - Zip Code:28513-2851
Practice Address - Country:US
Practice Address - Phone:252-524-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician