Healthcare Provider Details

I. General information

NPI: 1336003078
Provider Name (Legal Business Name): JESSICA GILESPIE SST,MA,CMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44671 BAYVIEW AVE APT 20201
CLINTON TOWNSHIP MI
48038-8206
US

IV. Provider business mailing address

44671 BAYVIEW AVE APT 20201
CLINTON TOWNSHIP MI
48038-8206
US

V. Phone/Fax

Practice location:
  • Phone: 586-945-3353
  • Fax:
Mailing address:
  • Phone: 586-945-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: