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Individual

MS. DIANE MONTGOMERY-LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
99 HALL ST, WINOOSKI, VT 05404-1738
(802) 860-9500
(802) 655-3963
Mailing address
99 HALL ST, WINOOSKI, VT 05404-1738
(802) 860-9500
(802) 655-3963

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
534
VT
103TP2701X
Group Psychotherapy Psychologist
Primary
534
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1004148
VT
Enumeration date
09/01/2006
Last updated
09/11/2025
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