Individual
ADDIE GRACE FETCKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
78 HOSPITAL RD, MACON, MS 39341-2490
(662) 726-4231
Mailing address
78 HOSPITAL RD, MACON, MS 39341-2490
(662) 726-4231
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S-5356
MS
Other
Enumeration date
01/14/2026
Last updated
01/14/2026
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