Individual
MICHAEL S CANNIZZARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
489 MAIN STREET, UNIVERSITY OF VERMONT POMEROY HALL, BURLINGTON, VT 05405-0130
(802) 656-3861
(802) 656-2528
Mailing address
489 MAIN STREET, UNIVERSITY OF VERMONT POMEROY HALL, BURLINGTON, VT 05405-0130
(802) 656-3861
(802) 656-2528
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
002958
CT
235Z00000X
Speech-Language Pathologist
Primary
1202944
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00069242
BLUE CROSS BLUE SHIELD
—
01
—
4148154
MVP
—
Enumeration date
03/13/2007
Last updated
09/11/2025
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