Healthcare Provider Details

I. General information

NPI: 1467114520
Provider Name (Legal Business Name): ALLISON MARIE WOLFSTAR LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2021
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 W KEN CARYL AVE
LITTLETON CO
80128-5756
US

IV. Provider business mailing address

6701 W KEN CARYL AVE
LITTLETON CO
80128-5756
US

V. Phone/Fax

Practice location:
  • Phone: 720-251-4640
  • Fax:
Mailing address:
  • Phone: 720-251-4640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU.0002487
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number3250
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: