Larson Pax Drzewicki, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101007571 Issued in MI

Practice address

1161 E Clark Rd Ste 360
Dewitt, MI 48820-7930

Phone

(517) 507-5525

NPI assigned

Nov 23, 2022

Last updated

Dec 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Larson Pax Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1356050868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412031",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412031",
            "telephone_number": "888-830-4125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 E CLARK RD STE 360",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488207930",
            "telephone_number": "517-507-5525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRZEWICKI",
        "first_name": "LARSON",
        "middle_name": "PAX",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-23",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101007571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LARSON",
            "last_name": "PAX",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mitchell Robert Dobrzelewski, OD
• Downtown Dewitt Chiropractic, P.C.
• Thomas John Doyle, O.D.
• Julia Drake, PT, DPT
• Jackie Drushel-Vanamburg, RDH
• Edward W. Sparrow Hospital Association (Sparrow Medical Group DeWitt)
• David Joseph Fedewa, D.M.D.
• Mary Margaret Fedewa, CRNP CNS
• Jana Marie Fisher, O.D.
• Emily Anne Fritz

• Speech-Language Pathologist in Dewitt, MI
• Providers in Dewitt, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.