Healthcare Provider Details

I. General information

NPI: 1285273177
Provider Name (Legal Business Name): DAISHA BONHOMME CPT, CHWC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2019
Last Update Date: 09/25/2025
Certification Date: 09/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8849 CEDAR GLEN DR
BATON ROUGE LA
70811-2406
US

IV. Provider business mailing address

8849 CEDAR GLEN DR
BATON ROUGE LA
70811-2406
US

V. Phone/Fax

Practice location:
  • Phone: 337-356-2895
  • Fax:
Mailing address:
  • Phone: 337-356-2895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number228686
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number228686
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: