Healthcare Provider Details

I. General information

NPI: 1164373148
Provider Name (Legal Business Name): DANA JO FISH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 US HIGHWAY 89 W
BROWNING MT
59417-8233
US

IV. Provider business mailing address

PO BOX 16
EAST GLACIER PARK MT
59434-0016
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-3200
  • Fax:
Mailing address:
  • Phone: 406-845-2603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBBH-ACLC-LIC-81840
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: