Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Tina Perre Wilde, CCCSLP

Individual provider Speech-Language Pathologist · NPI 1700923711

Mrs. Tina Perre Wilde, CCCSLP is a Speech-Language Pathologist in Bayport, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007
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Practice location Address checks out

404 1st Ave
Bayport, NY 11705-1305
Phone: (631) 472-6679
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 006180-1 (NY)

Record details

NPI number1700923711
Entity typeIndividual (Type 1)
GenderFemale
Credentials CCCSLP
Sole proprietorYes
NPI enumeratedJanuary 31, 2007
Last updated in NPPESJuly 8, 2007

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