Provider Demographics
NPI:1659024420
Name:THORSTAD, TARYN (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:THORSTAD
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S HAYNES AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:MILES CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59301-4779
Mailing Address - Country:US
Mailing Address - Phone:406-233-4327
Mailing Address - Fax:
Practice Address - Street 1:205 S HAYNES AVE STE 2
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-4779
Practice Address - Country:US
Practice Address - Phone:062-334-3274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-01
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSLP-AU-LIC-12822237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty