| Doctor Name: | DR. GRETA RAAEN |
| NPI Number: | 1497179873 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D., LPC |
| License Number: | 002245 |
| Business Practice Address: | 1224 Mill St Bldg B East Berlin, CT - 060231159 |
| Business Phone Number: | 8608935628 |
| Business Fax Number: | |
| Mailing Address: | 8105 Town Rdg, MIDDLETOWN |
| State: | CT |
| Postal Code: | 064576550 |
| Phone Number: | 8452044333 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2014 |
| NPI Last Update Date: | 02/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 002245 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |