Provider Demographics
NPI:1073035903
Name:JAMES, ANNETTE C
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:C
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 MICHAEL CIR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6111
Mailing Address - Country:US
Mailing Address - Phone:662-401-1712
Mailing Address - Fax:
Practice Address - Street 1:1800 W MAIN ST STE 10
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-3256
Practice Address - Country:US
Practice Address - Phone:662-401-1712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS814101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional