Individual
DR. MARK LINDEN PROHASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
100 RICE MINE ROAD, SUITE 303, TUSCALOOSA, AL 35406
(205) 344-6169
(205) 344-6171
Mailing address
100 RICE MINE ROAD, SUITE 303, TUSCALOOSA, AL 35406
(205) 344-6169
(205) 344-6171
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
816
AL
103T00000X
Psychologist
816
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51504930
BLUE CROSS
AL
Enumeration date
01/10/2007
Last updated
02/06/2009
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