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General NPI Number Information
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NPI Number | 1417807827
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Entity Type | Organization
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Legal Business Name | JESSI LEE LLC
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Dates
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Enumeration Date | 02/03/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 6561 RIDGEWOOD RD
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City | CLARKSTON
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State | MI
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Zip | 48346-1024
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Country | US
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Telephone | 248-326-8828
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Fax |
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Provider Business Mailing Address
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Address Line | 6561 RIDGEWOOD RD
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City | CLARKSTON
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State | MI
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Zip | 48346-1024
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Country | US
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Telephone | 248-326-8828
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MS. JESSICA LEE GOLDING
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Credential | RDN
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Telephone | 248-326-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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