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Contact Information

LESLIE A MASTBAUM
114 S MAIN ST
LANCASTER, SC29720
 Phone: 803-285-6911
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for LESLIE A MASTBAUM · (Female)

NPI Number 1063992964
Status Active
Credentials
Entity Individual
Enumeration date 08/20/2018
Last updated 08/23/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • SC Medicaid 230852
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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