Organization
MIMO BACKFIN BLUES
Active
Parent organization
RESILIENCE ACADEMY
Other names
Resilience Academy
Organization subpart
Yes
Provider details
NPI number
Legal business name
RESILIENCE ACADEMY
Authorized official
LULA MOULTRIE HEATLEY MSW, MRC, LCSW-C (THERAPIST)
(240) 273-8062
Entity
Organization
Contact information
Practice address
500 EDGEWOOD RD STE 202, EDGEWOOD, MD 21040-2734
(443) 967-4656
(443) 449-7573
Mailing address
500 EDGEWOOD RD STE 202, EDGEWOOD, MD 21040-2734
(443) 967-4656
(443) 449-7573
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/23/2025
Last updated
10/23/2025
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