Individual ProviderJacquelynn HollmanPsychologistBehavioral Health & Social Service ProvidersPractice Address42009 Victory Ln, Leesburg, VA 20176-6269(330) 758-4515PECOS EnrollmentBased on the most recent information from CMS, provider Jacquelynn Hollman does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1710209952Provider TypeIndividualFull NameHollman, JacquelynnGenderFemaleSole ProprietorNoEnumeration Date2/15/2010Last Updated2/15/2010Contact InformationPractice LocationPractice Address42009 Victory Ln, Leesburg, VA 20176-6269Phone(330) 758-4515Fax(330) 758-2862Mailing LocationMailing Address42009 Victory Ln, Leesburg, VA 20176-6269Phone(330) 758-4515Fax(330) 758-2862Provider TaxonomiesCodeDescriptionLicenseCode103TC0700XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicense0810004223Virginia