Neuropsychology Clinic | |
2804 20th Ave Northport AL 35476-3835 | |
(205) 333-1404 | |
(205) 333-1516 |
Full Name | Neuropsychology Clinic |
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Speciality | Clinical Neuropsychologist |
Location | 2804 20th Ave, Northport, Alabama |
Authorized Official Name and Position | Mark L Prohaska (DIRECTOR) |
Authorized Official Contact | 2053446169 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Neuropsychology Clinic 2804 20th Ave Northport AL 35476-3835 Ph: (205) 333-1404 | Neuropsychology Clinic 2804 20th Ave Northport AL 35476-3835 Ph: (205) 333-1404 |
NPI Number | 1093996985 |
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Provider Enumeration Date | 11/19/2007 |
Last Update Date | 05/05/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093996985 | NPI | - | NPPES |
51504930 | Other | AL | BLUE CROSS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103G00000X | Clinical Neuropsychologist | 816 (Alabama) | Primary |
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