MEDICARE: JESSICA GILESPIE SST,MA,CMA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1336003078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA GILESPIE SST,MA,CMA

Provider Business Mailing Address
First Line	:	44671 BAYVIEW AVE APT 20201
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-8206
Country	:	US
Telephone Number	:	586-945-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	44671 BAYVIEW AVE APT 20201
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48038-8206
Country	:	US
Telephone Number	:	586-945-3353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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