Individual
GENESIS LIGHTBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3925 MARTIN LUTHER KING B, SUITE 212, NORTH LAS VEGAS, NV 89032
(702) 503-9544
Mailing address
1640 E FLAMINGO RD, #100, LAS VEGAS, NV 89119-5249
(702) 503-9544
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
12959-C
NV
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/09/2012
Last updated
03/11/2026
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