Provider Demographics
NPI:1902535040
Name:HOLTER, CARLOTTA JO (MSGC)
Entity Type:Individual
Prefix:
First Name:CARLOTTA
Middle Name:JO
Last Name:HOLTER
Suffix:
Gender:F
Credentials:MSGC
Other - Prefix:
Other - First Name:CARLOTTA
Other - Middle Name:JO
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1930 E CAPITOL AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-2384
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1800 E INTERSTATE AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1399
Practice Address - Country:US
Practice Address - Phone:701-323-6543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS