Healthcare Provider Details

I. General information

NPI: 1215863410
Provider Name (Legal Business Name): MB THERAPY AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 DODGE ST STE D5
DUBUQUE IA
52003-7161
US

IV. Provider business mailing address

840 VALENTINE DR
DUBUQUE IA
52003-0216
US

V. Phone/Fax

Practice location:
  • Phone: 563-341-7031
  • Fax:
Mailing address:
  • Phone: 641-521-5835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MACKENZIE M BAKER
Title or Position: OWNER
Credential: LISW
Phone: 563-341-7031