Provider Demographics
NPI:1356875660
Name:CASANOVA, GERMANIE MARLENE (MS,MS)
Entity type:Individual
Prefix:MRS
First Name:GERMANIE
Middle Name:MARLENE
Last Name:CASANOVA
Suffix:
Gender:F
Credentials:MS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 NE 204 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179
Mailing Address - Country:US
Mailing Address - Phone:786-287-6017
Mailing Address - Fax:
Practice Address - Street 1:1300 NE 204 STREET
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179
Practice Address - Country:US
Practice Address - Phone:786-287-6017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-13
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health