Provider Demographics
NPI:1255405080
Name:FILTER, TERRANCE ANDERSON (PHD)
Entity type:Individual
Prefix:DR
First Name:TERRANCE
Middle Name:ANDERSON
Last Name:FILTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 INDEPENDENCE BLVD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6302
Mailing Address - Country:US
Mailing Address - Phone:248-705-7756
Mailing Address - Fax:248-594-7663
Practice Address - Street 1:206 S 5TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2229
Practice Address - Country:US
Practice Address - Phone:734-662-3385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002609103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI620H4600OtherBLUE CROSS OF MI
MI620H4600OtherBLUE CROSS OF MI
MI62OH04600Medicare ID - Type Unspecified