Provider Demographics
NPI:1760273478
Name:HARRIS-NEELY, DEBRA (RBT25429071)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:HARRIS-NEELY
Suffix:
Gender:F
Credentials:RBT25429071
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 W ARTHUR AVE APT 4W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5527
Mailing Address - Country:US
Mailing Address - Phone:773-354-0892
Mailing Address - Fax:773-354-0892
Practice Address - Street 1:2118 W ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5527
Practice Address - Country:US
Practice Address - Phone:773-759-5849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILRBT25429071106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician