Provider Demographics
NPI:1467114520
Name:WOLFSTAR, ALLISON MARIE (LAC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:WOLFSTAR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 W KEN CARYL AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-5756
Mailing Address - Country:US
Mailing Address - Phone:720-251-4640
Mailing Address - Fax:
Practice Address - Street 1:6701 W KEN CARYL AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-5756
Practice Address - Country:US
Practice Address - Phone:720-251-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-06
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO133NN1002X
CO3250374J00000X
COACU.0002487171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No374J00000XNursing Service Related ProvidersDoula