Provider Demographics
NPI:1184370694
Name:HOLMAN, ANDREA NICOLE O'CONNOR
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE O'CONNOR
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 HUDGINS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-4172
Mailing Address - Country:US
Mailing Address - Phone:540-907-0121
Mailing Address - Fax:866-832-7890
Practice Address - Street 1:420 HUDGINS RD STE 201
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-4172
Practice Address - Country:US
Practice Address - Phone:540-621-5061
Practice Address - Fax:866-832-7890
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701011191101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional