Individual
MRS. OLGA VIKTOROVNA SAMSONOVA-JELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT-BC
Contact information
Practice address
3098 MACE AVE APT C, COSTA MESA, CA 92626-2546
(714) 308-1023
Mailing address
3098 MACE AVE APT C, COSTA MESA, CA 92626-2546
(714) 308-1023
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
09262
—
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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