Provider Demographics
NPI:1053899344
Name:RAHMAN-FILIPIAK, ANNALISE MARIE (PHD)
Entity type:Individual
Prefix:
First Name:ANNALISE
Middle Name:MARIE
Last Name:RAHMAN-FILIPIAK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANNALISE
Other - Middle Name:MARIE
Other - Last Name:RAHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:2101 COMMONWEALTH BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-2969
Practice Address - Country:US
Practice Address - Phone:800-525-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-30
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301016966103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist