Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 0810002152 | VA |
NPI | 1003146473 |
---|---|
Provider Name | Dr. Holiday Rondeau |
First Address | Purcellville, VA 20134-0374 |
Second Address | Leesburg, VA 20175-3115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/01/2010 |
Last Update Date | 07/01/2010 |