# PERSONAL WELLNESS SOLUTIONS, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164827838
- **Authorized official:** ALICIA ANNE DIVICO (OWNER)
- **Authorized official phone:** (813) 384-4215

## Contact information

- **Practice address:** 13801 N DALE MABRY HWY STE 200, TAMPA, FL 33618-2412
- **Practice address phone:** (813) 390-1425
- **Mailing address:** 13801 N DALE MABRY HWY STE 200, TAMPA, FL 33618-2412
- **Mailing address phone:** (813) 390-1425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | MH11494 | FL | Yes |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |

## Other

- **Enumeration date:** 10/23/2014
- **Last updated:** 07/28/2023