Individual
ALICIA ANNE DIVICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
550 N REO ST STE 240, TAMPA, FL 33609-1062
(813) 435-3060
Mailing address
4511 N HIMES AVE, SUITE 200, TAMPA, FL 33614-7074
(813) 546-0585
(813) 449-4421
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH11494
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007383800
—
FL
Enumeration date
11/15/2012
Last updated
03/31/2022
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