Provider Demographics
NPI:1922250869
Name:DETREMPE, ATHENA (MSW)
Entity Type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:DETREMPE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ATHENA
Other - Middle Name:
Other - Last Name:ZUBIZARETA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 720
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76307-0720
Mailing Address - Country:US
Mailing Address - Phone:940-766-6306
Mailing Address - Fax:940-761-1698
Practice Address - Street 1:200 MARTIN LUTHER KING BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-1152
Practice Address - Country:US
Practice Address - Phone:940-766-6306
Practice Address - Fax:940-761-1698
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2015-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW - 316201041C0700X
TX600041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical