Provider Demographics
NPI:1538808472
Name:LITZINGER, THOMAS L (EDD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:LITZINGER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6374 SYCAMORE VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-8899
Mailing Address - Country:US
Mailing Address - Phone:586-215-9796
Mailing Address - Fax:
Practice Address - Street 1:6374 SYCAMORE VIEW DR
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-8899
Practice Address - Country:US
Practice Address - Phone:586-215-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6352000372103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral