Provider Demographics
NPI:1003146473
Name:RONDEAU, HOLIDAY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:HOLIDAY
Middle Name:
Last Name:RONDEAU
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 374
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20134-0374
Mailing Address - Country:US
Mailing Address - Phone:540-882-9080
Mailing Address - Fax:540-882-9310
Practice Address - Street 1:215 LOUDOUN ST SE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3115
Practice Address - Country:US
Practice Address - Phone:540-882-9080
Practice Address - Fax:540-882-9310
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810002152103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent