Provider Demographics
NPI:1295065910
Name:BUCKINGHAM, ARISTA (BS)
Entity type:Individual
Prefix:MRS
First Name:ARISTA
Middle Name:
Last Name:BUCKINGHAM
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 7TH ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:IA
Mailing Address - Zip Code:50036-2838
Mailing Address - Country:US
Mailing Address - Phone:515-433-0995
Mailing Address - Fax:515-433-0989
Practice Address - Street 1:420 KELLOGG AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6226
Practice Address - Country:US
Practice Address - Phone:515-233-3141
Practice Address - Fax:515-233-2440
Is Sole Proprietor?:No
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)