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General NPI Number Information
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NPI Number | 1306741434
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Entity Type | Organization
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Legal Business Name | SOLACE MIND & WELLNESS
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 9504 LIBERTY RD
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2704
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Country | US
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Telephone | 410-357-1121
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Fax |
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Provider Business Mailing Address
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Address Line | 9603 DEERECO RD UNIT 5316
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City | TIMONIUM
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State | MD
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Zip | 21094-7575
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Country | US
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Telephone | 410-357-1121
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Fax |
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Authorized Official
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Title or Position | OFFICE STAFF
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Name | SHAYLA EVANS
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Credential | NP
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Telephone | 410-357-1121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State | NULL
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