Healthcare Provider Details

I. General information

NPI: 1538808472
Provider Name (Legal Business Name): THOMAS L LITZINGER ED.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 E EISENHOWER PKWY
ANN ARBOR MI
48108-3231
US

IV. Provider business mailing address

3200 E EISENHOWER PKWY
ANN ARBOR MI
48108-3231
US

V. Phone/Fax

Practice location:
  • Phone: 734-677-0070
  • Fax: 734-677-0890
Mailing address:
  • Phone: 734-677-0070
  • Fax: 734-677-0890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number6352000372
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: