| Prokids, Inc. | |
|
321 Alpine St Mobile AL 36611-2434 | |
| (251) 457-4170 | |
| (251) 259-5177 |
| Full Name | Prokids, Inc. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 321 Alpine St, Mobile, Alabama |
| Authorized Official Name and Position | David Louis Roberts (PRESIDENT/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2514574170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prokids, Inc. Po Box 11452 Mobile AL 36671-0452 Ph: (251) 457-4170 | Prokids, Inc. 321 Alpine St Mobile AL 36611-2434 Ph: (251) 457-4170 |
| NPI Number | 1235365172 |
|---|---|
| Provider Enumeration Date | 06/05/2009 |
| Last Update Date | 06/05/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235365172 | NPI | - | NPPES |
| 890013780 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | AL1353 (Alabama) | Primary |
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