Healthcare Provider Details

I. General information

NPI: 1588501746
Provider Name (Legal Business Name): SAMANTHA GREGOIRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 ELM ST STE 34
WEST SPRINGFIELD MA
01089-1540
US

IV. Provider business mailing address

114 HADLEY VILLAGE RD
SOUTH HADLEY MA
01075-2190
US

V. Phone/Fax

Practice location:
  • Phone: 413-734-0107
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: