Provider Demographics
NPI:1538963103
Name:BUCKLEY, ARIELLE (RDN)
Entity type:Individual
Prefix:
First Name:ARIELLE
Middle Name:
Last Name:BUCKLEY
Suffix:
Gender:
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-2125
Mailing Address - Country:US
Mailing Address - Phone:989-780-1616
Mailing Address - Fax:
Practice Address - Street 1:440 BALDWIN AVE APT 56
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-2126
Practice Address - Country:US
Practice Address - Phone:989-780-1616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered