Provider Demographics
NPI:1386113249
Name:SOFIALI-BRUNVERT, YIOLANTA (LMHC, PHD)
Entity type:Individual
Prefix:DR
First Name:YIOLANTA
Middle Name:
Last Name:SOFIALI-BRUNVERT
Suffix:
Gender:F
Credentials:LMHC, PHD
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:
Other - Last Name:SOFIALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:873 SPRINGDALE CIR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-1527
Mailing Address - Country:US
Mailing Address - Phone:561-660-1692
Mailing Address - Fax:
Practice Address - Street 1:2499 GLADES RD STE 107
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-7260
Practice Address - Country:US
Practice Address - Phone:561-660-1692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health