Provider Demographics
NPI:1962705459
Name:SOLUM, SHARON K (LMFT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:K
Last Name:SOLUM
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 1:509 25TH AVE N
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58102-1938
Mailing Address - Country:US
Mailing Address - Phone:701-232-6224
Mailing Address - Fax:701-232-4687
Practice Address - Street 1:509 25TH AVE N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-1938
Practice Address - Country:US
Practice Address - Phone:701-232-6224
Practice Address - Fax:701-232-4687
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND2009-013106H00000X
MN1795106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist