Individual provider · Type 1 NPI

Blake Nicole Gibson, M.S., CCC-SLP

Speech-Language Pathologist · Fort Worth, TX

NPI number 1104743863 Active

Practice location

4901 Bryant Irvin Rd N Ste 200
Fort Worth, TX 76107-7673

Call (817) 433-9742 Map

Mailing address

10917 Los Rios Dr
Fort Worth, TX 76179-6842

Specialties and licenses

TaxonomyCodeLicense
Speech-Language Pathologist Primary 235Z00000X122638 (TX)

Speech-Language Pathologist: The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonan…

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About NPI 1104743863

Blake Nicole Gibson, M.S., CCC-SLP's National Provider Identifier is 1104743863, issued on Jul 2, 2026. The primary taxonomy on file is Speech-Language Pathologist (235Z00000X), and the practice location is in Fort Worth, TX. The record was last updated on Jul 2, 2026.