Provider Demographics
NPI:1477685972
Name:FROOM, SHARON G (LLP)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:G
Last Name:FROOM
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 CANTERBURY AVE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-2739
Mailing Address - Country:US
Mailing Address - Phone:269-381-0769
Mailing Address - Fax:269-381-0195
Practice Address - Street 1:421 MONROE ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-4437
Practice Address - Country:US
Practice Address - Phone:269-381-8917
Practice Address - Fax:269-381-8917
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007862103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling