Healthcare Provider Details

I. General information

NPI: 1023922432
Provider Name (Legal Business Name): TERESA CASANOVA HAASE CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 E GENESEE AVE FL 3
SAGINAW MI
48607-1242
US

IV. Provider business mailing address

301 E GENESEE AVE FL 3
SAGINAW MI
48607-1242
US

V. Phone/Fax

Practice location:
  • Phone: 989-415-8023
  • Fax:
Mailing address:
  • Phone: 920-309-0977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: