Healthcare Provider Details

I. General information

NPI: 1356267900
Provider Name (Legal Business Name): SACRED MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2191 DEFENSE HWY STE 312
CROFTON MD
21114-2941
US

IV. Provider business mailing address

2631 HOUSLEY RD # 1092
ANNAPOLIS MD
21401-7030
US

V. Phone/Fax

Practice location:
  • Phone: 443-267-4325
  • Fax: 443-782-2251
Mailing address:
  • Phone: 443-267-4325
  • Fax: 443-782-2251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: AMY STAHLER
Title or Position: OWNER / PRACTITIONER
Credential: LAC
Phone: 443-267-4325