Healthcare Provider Details

I. General information

NPI: 1083555890
Provider Name (Legal Business Name): WILD AND WONDERFUL LIFE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 W 56TH AVE UNIT 100
ARVADA CO
80002-2807
US

IV. Provider business mailing address

5511 W 56TH AVE UNIT 100
ARVADA CO
80002-2807
US

V. Phone/Fax

Practice location:
  • Phone: 708-740-0136
  • Fax:
Mailing address:
  • Phone: 708-740-0136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ALEYA LITTLETON
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: MA, LPC
Phone: 570-909-7529