Provider Demographics
NPI:1124780937
Name:HARRIS, DEBORAH ANN (RPRS)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:ANN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:RPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5998 PROVIDENCE RD STE 106A
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3828
Mailing Address - Country:US
Mailing Address - Phone:757-891-5922
Mailing Address - Fax:
Practice Address - Street 1:5998 PROVIDENCE RD STE 106A
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3828
Practice Address - Country:US
Practice Address - Phone:757-891-5922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0735000380175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist