Individual
MR. MARK CANNIZZARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
120 N WASHINGTON SQ STE 300, LANSING, MI 48933-1658
(734) 210-1854
(517) 627-1289
Mailing address
120 N WASHINGTON SQ STE 300, LANSING, MI 48933-1658
(734) 210-1854
(517) 627-1289
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012725
MI
Other
Enumeration date
01/18/2007
Last updated
03/13/2020
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