Individual
GINA MANROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAC-21925
Contact information
Practice address
2630 E LASS AVE, KINGMAN, AZ 86409-1354
(480) 356-6721
Mailing address
2630 E LASS AVE, KINGMAN, AZ 86409-1354
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
21925
AZ
Other
Enumeration date
03/10/2026
Last updated
03/10/2026
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