Healthcare Provider Details

I. General information

NPI: 1881426609
Provider Name (Legal Business Name): MADELINE GRACE GETZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MADELINE GRACE BENNETT

II. Dates (important events)

Enumeration Date: 08/19/2024
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LIME QUARRY RD
MADISON AL
35758-8961
US

IV. Provider business mailing address

402 BAY TREE LN SW
HUNTSVILLE AL
35824-4071
US

V. Phone/Fax

Practice location:
  • Phone: 256-542-1970
  • Fax:
Mailing address:
  • Phone: 501-765-0808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6186
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: