Individual
LOGAN R GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
34 BARRE ST, MONTPELIER, VT 05602-3510
(802) 301-3200
(802) 223-0842
Mailing address
PO BOX 647, MONTPELIER, VT 05601-0647
(802) 301-3200
(802) 223-0842
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
097.0136531
VT
Other
Enumeration date
07/03/2025
Last updated
12/10/2025
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