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Individual

OLENA FOSFOROVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMBT

Contact information

Practice address
1100 S MINT ST STE 109, CHARLOTTE, NC 28203-4058
(704) 763-9044
Mailing address
1100 S MINT ST STE 109, CHARLOTTE, NC 28203-4058
(704) 763-9044

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12549
NC

Other

Enumeration date
05/15/2017
Last updated
07/21/2022
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