MEDICARE: WILDER VOICES THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1164367041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILDER VOICES THERAPY LLC

Provider Business Mailing Address
First Line	:	3215 DILDAY DR
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89701-6115
Country	:	US
Telephone Number	:	760-914-2252
Fax Number	:

Provider Business Practice Location Address
First Line	:	3215 DILDAY DR
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89701-6115
Country	:	US
Telephone Number	:	760-914-2252
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CARLIE WILDERS
Credential	:	M.S. CCC-SLP
Telephone Number	:	760-914-2252

Provider Enumeration Date	:	04/20/2026
Last Update Date	:	04/20/2026

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Directions to “WILDER VOICES THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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