Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ethan Kristek, MS, CCC-SLP

Individual provider Speech-Language Pathologist · NPI 1629420369

Mr. Ethan Kristek, MS, CCC-SLP is a Speech-Language Pathologist in Mount Vernon, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2016
What do these letters mean?
MS — Master of Science
A graduate science degree.
CCC-SLP — Certificate of Clinical Competence in Speech-Language Pathology
A speech-language pathologist certified by ASHA.

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Practice location Address checks out

1600 S Hickory St
Mount Vernon, MO 65712-2045
Phone: (417) 466-7103
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 2016020591 (MO)

Record details

NPI number1629420369
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , CCC-SLP
Sole proprietorYes
NPI enumeratedJuly 6, 2016
Last updated in NPPESJuly 6, 2016

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