Healthcare Provider Details

I. General information

NPI: 1437060803
Provider Name (Legal Business Name): BAILEY JESSICA ALISSE FAIRMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BEE JESSICA ALISSE FAIRMAN

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5399 PIERCE ST APT C1
ALLENDALE MI
49401-8233
US

IV. Provider business mailing address

5399 PIERCE ST APT C1
ALLENDALE MI
49401-8233
US

V. Phone/Fax

Practice location:
  • Phone: 586-588-4936
  • Fax:
Mailing address:
  • Phone: 586-588-4936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: