Healthcare Provider Details

I. General information

NPI: 1477489912
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

Practice location:
  • Phone: 540-514-3358
  • Fax:
Mailing address:
  • Phone: 540-514-3358
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: KRISTAN PERRY-ROBINSON
Title or Position: OWNER
Credential:
Phone: 540-514-3358