Provider Demographics
NPI:1689449209
Name:FLOM, SHARON ANNA (LMFT)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANNA
Last Name:FLOM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 PARK GLEN RD APT 105
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4836
Mailing Address - Country:US
Mailing Address - Phone:507-319-7479
Mailing Address - Fax:
Practice Address - Street 1:6600 FRANCE AVE S STE 472
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1806
Practice Address - Country:US
Practice Address - Phone:651-454-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3823106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist