MEDICARE: SHANTARA LYNN HECKARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	OH
2	374U00000X	Home Health Aide	OH
3	3747A0650X	Attendant Care Provider	OH

General Provider Information

NPI Number	:	1871452706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANTARA LYNN HECKARD

Provider Business Mailing Address
First Line	:	1661 NEBRASKA AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-3904
Country	:	US
Telephone Number	:	419-356-9356
Fax Number	:

Provider Business Practice Location Address
First Line	:	1661 NEBRASKA AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43607-3904
Country	:	US
Telephone Number	:	419-356-9356
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “ SHANTARA LYNN HECKARD ” Practice Location

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