Provider Demographics
NPI:1982030771
Name:WIGGINS, SAMANTHA ELENA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:ELENA
Last Name:WIGGINS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MISS
Other - First Name:SAMANTHA
Other - Middle Name:ELENA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 BOBALA RD
Mailing Address - Street 2:
Mailing Address - City:HOLYOKE
Mailing Address - State:MA
Mailing Address - Zip Code:01040-9632
Mailing Address - Country:US
Mailing Address - Phone:413-536-5473
Mailing Address - Fax:
Practice Address - Street 1:40 BOBALA RD
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-9632
Practice Address - Country:US
Practice Address - Phone:413-536-5473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker