OrganizationActive
Neuropsychology Clinic
NPI 1093996985 · Clinical Neuropsychologist · Northport, AL
Provider details
- NPI number
- 1093996985
- Entity type
- Organization
- Primary specialty
- Clinical NeuropsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Mark Prohaska, Director(205) 344-6169
- License
- 816 (AL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
2804 20th Ave
Northport, AL 35476-3835
Phone: (205) 333-1404
Fax: (205) 333-1516
Approximate (ZIP-level) locationGet directions
Mailing address
2804 20th Ave
Northport, AL 35476-3835
Registry dates
- Enumerated
- 2007-11-19
- Last updated
- 2010-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.