Healthcare Provider Details
I. General information
NPI: 1932035508
Provider Name (Legal Business Name): THE SOUL CARE PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
306 W REDWOOD ST # 200
BALTIMORE MD
21201-1708
US
IV. Provider business mailing address
201 E PATRICK ST # 3712
FREDERICK MD
21701-5631
US
V. Phone/Fax
- Phone: 540-514-3358
- Fax:
- Phone: 540-514-3358
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRISTAN
PERRY-ROBINSON
Title or Position: OWNER
Credential:
Phone: 540-514-3358