Basic Information
| Provider Information | |||||||||
| NPI: | 1003146473 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RONDEAU | ||||||||
| FirstName: | HOLIDAY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 374 | ||||||||
| Address2: | |||||||||
| City: | PURCELLVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201340374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408829080 | ||||||||
| FaxNumber: | 5408829310 | ||||||||
| Practice Location | |||||||||
| Address1: | 215 LOUDOUN ST SE | ||||||||
| Address2: | |||||||||
| City: | LEESBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 201753115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408829080 | ||||||||
| FaxNumber: | 5408829310 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/07/2010 | ||||||||
| LastUpdateDate: | 01/07/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC2200X | 0810002152 | VA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent |
No ID Information.